Abstract
Background: Arrhythmia is the most common complication after transcatheter closure of a ventricular septal defect (VSD). However, the effects of postprocedural left anterior fascicular block are not clear. This study presents the clinical characteristics, prognosis, and related risk factors of left anterior fascicular block after transcatheter closure of a VSD in children.Methods: The clinical and follow-up data of the patients in the Heart Center of Children's Hospital of Chongqing Medical University from June 2009 to October 2018 were reviewed. And 30 cases were eligible out of all 1,371 cases.Results: An electrocardiogram showed a left anterior fascicular block within 3 days, and most patients gradually returned to normal within 1–2 years, showing a dynamic change. Left ventricular end-diastolic dimension Z-score ranged from −2 to 2 in all children, and no decrease of left ventricular ejection fraction was found in all children. The high ratio between VSD size and body surface area [p < 0.05, odds ratio (OR) 2.6, 95% CI: 1.136–6.113] and large diameter difference between the occluder size and VSD size (p < 0.05, OR 2.1, 95% CI: 1.036–4.609) were independent risk factors for postprocedural left anterior fascicular block.Conclusions: The incidence of postprocedural left anterior fascicular block is not that low, and the overall prognosis is quite good at the current follow-up stage. No progressive severity has been found, such as complete left bundle branch block, double (triple) bundle branch block, and atrioventricular block, to have an influence on cardiac systolic and diastolic function.
Highlights
Ventricular septal defect (VSD) is one of the most common congenital heart diseases (CHDs) in children
Given the importance of the left ventricle to the whole circulation system, many other postprocedural blocks, such as the second degree type II atrioventricular block (AVB) or above and complete left bundle branch block (CLBBB) that have an influence on hemodynamics and left ventricular function to varying degrees, were specialized in and described in detail previously [3,4,5]
Left anterior fascicular block (LAFB), or left anterior bundle branch block, one type of left bundle branch block (LBBB), can result in a certain degree of ventricular asynchrony theoretically affecting hemodynamics and left ventricular function; more attention should be paid to this aspect as well
Summary
Ventricular septal defect (VSD) is one of the most common congenital heart diseases (CHDs) in children. What we cannot ignore is postprocedural arrhythmias, the most common complication after the closure, Risk Factors for Postprocedural LAFB including atrioventricular block (AVB), bundle branch block (BBB), non-sinus tachycardia, and frequent premature contractions, etc. Given the importance of the left ventricle to the whole circulation system, many other postprocedural blocks, such as the second degree type II AVB or above and complete left bundle branch block (CLBBB) that have an influence on hemodynamics and left ventricular function to varying degrees, were specialized in and described in detail previously [3,4,5]. We aim to determine the clinical characteristics, follow-up outcomes, and related risk factors of LAFB after transcatheter closure of a VSD in children. This study presents the clinical characteristics, prognosis, and related risk factors of left anterior fascicular block after transcatheter closure of a VSD in children
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