Electrocardiographic Changes in the Early and Late Periods After Percutaneous Balloon Pulmonary Valvuloplasty

The electrocardiographic changes observed both during and after percutancous balloon pulmonary valvuloplasty procedure that had been performed in the 32 patients at the ardiology Clinic of the Yüksek İhtisas Hospital of Turkey, were evaluated. Sinus bradycardia was seen in 2 cases (6 %), ventricular and supraventricular premature contractions in 13 (40 %), transient complete right bundle branch block in 4 (12 %) and juctional tachycardia in 1 patient (3 %) during the procedure. Second degree AV block, and then an accelerated AV junctional rhythm developed in 1 patient (3 %). Morcover, it was observed that the initial QTc interval, 404±39 msec, had prolonged up to its peak value, 449±20 msec, within 24 hours after the procedure (p<0.01) and returned gradually to the initial values, 410±20 msec, one month later (p>0.05). All patients had a mean 118±30 degree of QRS axis before the procedure and right ventricular hypertrophy was noted in 24 cases (75 %). In 25 cases with a follow-up the mean QRS axis decreased from 121±29 to 105±30 degree after a period of 6-24 months (p<0.05). 19 of those patients showed the pattern of ventricular hypertrophy disappcared in 4, regressed in 10 and was unchanged in 5 patients. Though no life threatening or persistent arrhythmia was noted during or after the procedure, we noticed the manifestations of minor traumatic effects of the ballon catheters on the conduction system during inflation.