Objective
In this retrospective study, we aimed to examine microvolt T-wave alternans (MTWA) in Holter electrocardiography (ECG) of children with repaired tetralogy of Fallot (TOF) to assess risk of sudden death and ventricular arrythmias. We tried to define correlation between MTWA and electrocardiographic, echocardiographic parameters, heart rate variability (HRV) as well.
Results
Thirty-five subjects (%62,5) were male and 21 (%37,5) were female. Mean age was 123,4 ± 48,3 months. All patients underwent total correction operation and eight (%14,3) patients had Blalock-Taussig shunt procedure before total correction. There was significant difference between patient and control groups, in terms of QRS duration, median QT dispersion, maximum and minimum mean duration of QT and QTc. We found RBBB in 37 patients (%66), monomorphic premature ventricular contractions in 8 (%14,3) and non-sustained ventricular tachycardia in 1 (%1,8). All HRV parameters except LF/HF ratio were found to be significantly lower in patient group than in control group. LF/HF ratio was significantly higher in patient group. Median MTWA value was 55,5 μV in the control group whereas 95,5 μV in patients group. MTWA was found to be significantly higher in patient group. A significant positive correlation was found between presence of premature ventricular contractions and tricuspid regurgitation; SDNN, SDNNi, TP, VLF and RV dilatation; SDNNi, TP, VLF and QRS duration; SDNN, SDNNi, rMSSD, pNN50, TP, VLF, LF, HF and maximum QT; SDNNi, rMSSD, pNN50, TP, VLF, LF, HF and minimum QT; SDNNi, TP, VLF, LF and QT dispersion. There was no correlation between HRV parameters, echocardiographic findings and MTWA.
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