Objective:To observe the changes of electrocardiography and cardiac function in children with ventricular septal defect intervention.Methods:A total of 51 children who underwent percutaneous closure of VSD in the Department of Cardiology,Anhui Children’s Hospital from August 2020 to June 2022 were selected for the study.ECG,24-hour ambulatory ECG and echocardiogram were recorded 3 days before surgery and 2 days after surgery.In addition to intraoperative cardiac monitoring,the ECG was performed 1,3 and 6 months after surgery during the process of establishing vascular intervention channels,plugging device implantation and pulling out sheath.Echocardiography was performed during the process of establishing vascular intervention channels,plugging device implantation and pulling out sheath.The occurrence of arrhythmias was recorded and all data were analysed in comparison with the preoperative period.Another 20 healthy children of similar sex and age were selected as controls for the ambulatory ECG in children with ventricular septal defect.Results:All 51 children were successfully blocked,and 2 cases of abnormal ECG changes before surgery,including 1 case with left ECG axis deviation,1 case with atrial premature beats,the ECG axis returned to normal during the intraoperative and postoperative follow-up period,and premature beats did not appear again.During the operation,4 cases of left anterior branch block,9 cases of right bundle branch block,1case of first-degree atrioventricular block,5 cases of left deviation of ECG axis,1 case of right deviation of ECG axis,3 cases of atrial premature beats,and all returned to normal after sheath extraction.There were 3 cases of left ECG axis deviation 2 days after surgery,of which 1 case returned to normal 1 month after surgery,and the other 2cases lasted until 3 months after surgery.Two cases of right bundle branch block appeared 1 month after surgery,which lasted until 3 months after surgery.1 case of ventricular premature beats occurred 3 months after surgery;Six months after surgery,1case of first-degree atrioventricular block and 1 case of left axis deviation occurred,and the rest of the ECG changes returned to normal.Compared with the preoperative period,the axial value of ECG decreased 2 days after implantation of the plugging device,removal of the sheath [(34.98±31.05)vs(-19.08±33.92)、(-17.04±29.06)and(25.17±39.09)] and recovered to the preoperative level one month after operation.The PR interval and QT interval were prolonged after implantation of plugging device[(134.71±11.47)vs(140.53±14.12);(341.98±25.55)vs(356.06±29.53)],returned to the preoperative level after sheath removal.The prolonged QTd[(5.53±2.37)VS(6.16±2.43)、(9.65±2.13)and(7.51±3.63)]、QTc[(421.12±22.62)VS(430.75±31.71)、(426.06±24.19)and(430.16±24.94)]、 and P-wave times[(91.57±9.96)VS(96.22±11.81)、(98.88±12.87)and(95.55±11.83)]of the interventional channel establishment,plugging device implantation and pulling out the sheath returned to normal 2 days after operation.Postoperative SDNN[(113.80±27.32)VS(135.15±39.44)],r MSSD[(49.19±23.28)VS(68.13±31.07)],and PNN50[(9.36±5.19)VS(13.15±5.98)]were elevated.All the above changes were statistically significant(p <0.05).Compared with the control group,the postoperative r MSSD [(43.90 ± 20.20)VS(68.13 ± 31.07)] and PNN50 [(7.35 ± 4.39)VS(13.15 ±5.98)] were elevated with statistically significant differences(p<0.05).Compared with the preoperative period,the EF [(66.88±5.26)VS(60.96±6.49)and(62.52±7.19)]and FS[(36.49±4.31)VS(31.87±4.55)and(33.16±5.01)] decreased after implantation of the plugging device and removal of the sheath.All the above changes were statistically significant,P < 0.05.Conclusion:1.VSD interventional closure can cause ECG changes,especially RBBB and left deviation of the ECG axis,but most of them recover or reduce during the observation period.2.There was an increase in cardiac vagal tone and a transient decrease in cardiac function parameters after VSD interventional blocking treatment. |