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Ventricular Inhomogeneity and Beat-to-beat QT Interval Variability after Surgical Repair of Tetralogy of Fallot

Journal of the Korean Pediatric Society 2001;44(4):418-425.
Published online April 15, 2001.
Ventricular Inhomogeneity and Beat-to-beat QT Interval Variability after Surgical Repair of Tetralogy of Fallot
Su-Hyun Kim1, Myung-Kul Yum1, Nam-Su Kim1, Chang-Ryul Kim1, Chul-Burm Lee2, Chung-Ill Noh3, Hee-Soo Kim4
1Department of Pediatrics, Hanyang University Kuri Hospital, Korea
2Department of Thoracic Surgery, Hanyang University Kuri Hospital,
3Department of Pediatrics, Seoul University Hospital, Korea
4Department of Anesthesiology, Seoul University Hospital, Korea
활로 4징 교정수술 환아에서 심실재분극의 불균일성과 QT간격변이 분석
김수현1, 염명걸1, 김남수1, 김창렬1, 이철범2, 노정일3, 김희수4
1한양대학교 의과대학 소아과학교실
2한양대학교 의과대학 흉부외과학교실
3서울대학교 의과대학 소아과학교실
4서울대학교 의과대학 마취과학교실
Correspondence: 
Myung-Kul Yum, Email: mkyumm@email.hanyang.ac.kr
Abstract
Purpose
: The object of this study is to determine whether QT interval variability in patients with postoperative tetralogy of Fallot increases.
Methods
: We enrolled 41 patients who had total correction of tetralogy of Fallot, and 31 healthy controls. They were 6-12 years old. Patients were divided into 2 groups : arrhythmia-positive patients(n=10) who had ventricular premature contractions more than 30/hour or who had couplets, and arrhythmia-negative patients(n=31). We selected the 10-minute arrhythmia-free portion of 24-hour ambulatory ECG recorded during sleep(1-3AM). We selected the 2nd beat of recordings for a template, then found the QT interval for each beat. The method was that T-wave shape best matches template T-wave under the time-stretch model. The mean heart rate and variance and mean QT interval and variance were computed and then a QT variability index(QTVI)-which represents the log ratio between QT interval variability and heart rate variability-was derived.
Results
: Postoperative tetralogy of Fallot patients with/without ventricular arrhythmia showed significantly increased QTVI compared with the control(-0.481¡¾0.310/-0.661¡¾0.376 vs -1.200¡¾0.380, P<0.0001). There was a trend that QTVI in patients with ventricular arrhythmia increased more than in patients without ventricular arrhythmia, but there were no statistical significances.
Conclusion
: QT interval variability increased in repaired tetralogy of Fallot patients with/without ventricular arrhythmia compared with the control. And this finding indicates that inhomogeneity of temporal ventricular repolarization exists in repaired tetralogy of Fallot patients.
Key Words: Tetralogy of fallot, Ventricular arrhythmia, Temporal ventricular repolarization inhomogeneity, QT variability index


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