Electrocardiographic Changes In Patients Research Articles

Electrocardiography changes and different stages of heart failure in central Iran: A cross-sectional study from Yazd Health Study.

Electrocardiography (ECG) is a widely accessible, noninvasive, and cost-effective diagnostic instrument used to evaluate patients with suspected heart failure (HF). The aim of this study is to investigate electrocardiographic changes in patients with different stages of HF in a random population of Yazd city. This prospective cross-sectional study included 319 individuals, randomly selected, aged 40 years and more, registered in the Yazd Health Study was conducted from March 2022 to May 2023 at Afshar Hospitals. In accordance with the AHA/ACC guidelines, HF was classified into four stages (A, B, C, and D). The 159 individuals were classified in the stage 0 group, 77 were in Stage A, 65 were in Stage B, and 18 were in Stage C of HF. In the Stage 0, the PR interval (PRi) was 130.5 ± 18.1 ms, while in Stage C, it was 143.3 ± 21.9 ms, with a significant difference (p = 0.047). Similarly, the QRS interval (QRSi) increased with HF staging (p = 0.001). The frequency of diabetes mellitus (DM), hypertension (HTN), hyperlipidemia (HLP), chronic heart disease, alcoholism, and PRi, QRSi, QT interval levels were independent predictors of HF stage in multivariate regression analysis. The prevalence of HF stages, as classified by the AHA/ACC guidelines, was observed, with significant correlations between ECG parameters and HF progression. abnormal rhythms, left bundle branch block, ischemia, hypertrophy, and left atrial enlargement increased with higher HF stages. Major risk factors like DM and HTN exhibited a heightened prevalence in advanced HF stages, accentuating their pivotal role in the progression of HF.

Relation of ECG Abnormalities to Clinical Severity and Troponin I Changes in Patients with Subarachnoid Hemorrhage

Relation of ECG Abnormalities to Clinical Severity and Troponin I Changes in Patients with Subarachnoid Hemorrhage

Electrocardiographic Changes with Age in Japanese Patients with Noonan Syndrome.

Little information is available on age-related electrocardiographic changes in patients with Noonan syndrome. This single-center study evaluated the electrocardiograms of patients with Noonan syndrome. We divided the patients (n = 112; electrocardiograms, 256) into four groups according to age: G1 (1 month-1 year), G2 (1-6 years), G3 (6-12 years), and G4 (>12 years). Typical Noonan syndrome-related electrocardiographic features such as left-axis deviation, abnormal Q wave, wide QRS complex, and small R wave in precordial leads were detected. A high percentage of QRS axis abnormalities was found in all groups. Significant differences in right-axis deviation (RAD) were noted among the groups: 56.5% of G1 patients showed RAD compared with 33.3% of G2, 21.1% of G3, and 19.2% of G4 patients. The small R was also significantly different among the groups: 32.6% of G1 patients showed a small R wave compared with 14.9% of G2, 8.5% of G3, and 15.4% of G4 patients. Of the 53 patients with Noonan syndrome aged 1 month to 2 years, 18 had T-positive V1 with a higher prevalence of pulmonary stenosis and cardiac interventions. QRS axis abnormalities, small R in V6, and T-positive V1 could help diagnose Noonan syndrome in infants or young children.

Changes in Electrocardiogram in Patients With Spontaneous Subarachnoid Hemorrhage: A Cross-Sectional Study.

Background Electrocardiographic (ECG) changes are frequently reported findings in patients with subarachnoid hemorrhage (SAH). We conducted a retrospective descriptive study to assess the prevalence of electrocardiographic changes in patients with non-traumatic SAH. Methods In this single-center retrospective cross-sectional study, ECG recordings of 45 patients who presented to Tribhuvan University Teaching Hospital in the year 2019 with SAH were collected and analyzed to detect any abnormalities. Results In our study, 88.8% of patients had some form of ECG abnormality. The most common ECG abnormalities associated with SAH were QTc prolongation, T-wave abnormalities, and bradycardia, which were found, respectively, in 35.5%, 24.4%, and 24.4% of the patients. Other ECG changes we observed include ST depression, large U-waves, atrial fibrillation, and premature ventricular contractions. Conclusion Morphological and rhythm abnormalities are frequently observed in patients with SAH, which may cause diagnostic dilemmas and unnecessary workups. Further studies are required to evaluate their significance and correlate ECG changes with clinical outcomes.

Electrocardiographic changes in patients with non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) has become a major public health problem worldwide. NAFLD is the most common chronic liver disease in developed countries and is estimated to affect 25 to 30 % of the adult population. Currently, NAFLD is considered as a multisystem disease that affects not only the liver, but also the cardiovascular system. Ultimately, these changes may be responsible for the increased cardiac morbidity and mortality associated with NAFLD. Consistent with this finding, and based on the fact that cardiovascular disease (CVD) complications often determine outcomes in patients with NAFLD, the clinical guidelines of the Russian Scientific Liver Society and the Russian Gastroenterological Association, as well as the European Clinical Practice Guidelines for the management of NAFLD recommend that a cardiovascular risk assessment should be performed in all NAFLD patients.

Correlation of Mean Heart Dose and Cardiac Biomarkers with Electrocardiographic Changes in Patients Receiving Thoracic Radiation Therapy.

Cardiotoxicity is a well-recognized, serious adverse effect of thoracic radiation therapy. This study aimed to evaluate longitudinal electrocardiogram (ECG) changes in patients receiving thoracic radiation therapy and identify correlating factors that can predict the risk of cardiotoxicity. This retrospective study included 202 patients treated with thoracic radiation therapy, and chemotherapy and targeted therapy were allowed. Mean heart dose (MHD) was evaluated on dose-volume histograms. ECG, high-sensitivity cardiac troponin T (hs-cTnT), and N-terminal B-type natriuretic peptide (NT-proBNP) analyses were conducted before irradiation and during the follow-up period of 6-12 months (average 8 months). Chi square test and logistic regression analysis were applied to identify risk factors associated with ECG changes. At a median time of 3 months postirradiation, 46.5% of patients showed ECG changes, and 33.0% of patients achieved baseline ECG levels during the follow-up period at a median of 5 months postirradiation. Logistic regression analysis identified MHD, hs-cTnT and NT-pro BNP as significant factors associated with ECG changes (P < 0.05). Hs-cTnT and NT-proBNP were increased significantly after radiation therapy compared with baseline levels (P < 0.05), and these increases were observed as a median time of 2 months postirradiation, which was earlier than ECG changes. Higher MHD and elevated hs-cTnT and NT-proBNP levels correlated with an increased risk of ECG changes in patients receiving thoracic radiation therapy. Early identification of patients at high risk of cardiotoxicity and timely intervention might reduce the incidence of radiation-induced cardiac toxicity.

An Observational Study of Vataja Hridroga in Correlation with Electrocardiographic Changes

Diagnosing a disease is far important before initiating the treatment. Different important and involuntary functions are regulated by different Dosha, Dhatu and Oja, which are situated in the heart. Hridroga is disease of Marma and is life threatening. However emphasis is given to explore the possibility of inclusion of electrocardiogram a bedside investigating tool as a support to existing Pramanas and Rugna pariksha. In accordance with the World Health Organization, India accounts for one-fifth of these deaths worldwide especially in younger population. So the study aimed at comprehension of electrocardiographic changes in patients suffering from Vataja Hridroga as mentioned in Charak samhita, Sushruta Samhita, Ashtanghridaya and their specific correlation. 100 patients were included in the study and their symptomatology with electrocardiographic changes was observed. Vata Pradhan Kapha-Pitta Anubandha observed in in 38% patients, Vata Pradhan Kapha Anubandha observed in 34% patients, Keval Vata Pradhanata observed in 23% patients, Vata Pradhan Pitta Anubandha observed in 5% patients. This Kapha-Pitta Anubandha indicates its contribution in Srotorodha Pradhan and Avaranatmak Samprapti. Dosha vitiation and Anubandha causes various pathological changes in Hridaya like Shotha, Paka, Srotorodh thereby leads to specific changes in electrocardiogram. Significant correlation between two were observed.

Electrocardiographic Changes in Patients with Depression after Using Escitalopram for a Short Period

Background&#x0D; Antidepressant drugs are most commonly used for management of depressive disorders. Antidepressant drugs used in psychiatric clinics may affect the electrical activity of the heart which may induce fatal cardiac events.&#x0D; Objectives&#x0D; The purpose of the current study is to reveal the outcomes of escitalopram use for short period of time on the ECG records applying the prolongation of (heart-rate corrected interval for assessing ventricular repolarization) QTc and (corrected JT interval) JTc intervals as a predictor of the negative effects of antidepressants.&#x0D; Methods&#x0D; Twenty-eight patients with major depressive disorder and 20 healthy participants were recruited. Parameters such as weight, height, and blood pressure measurements were determined. Electrocardiographic (ECG) records and echocardiographic records [for ejection fraction (%)] were obtained before administration of escitalopram and after 4 weeks of treatment with daily escitalopram 10 mg. The intervals of JTc and QTc and the voltage criteria (R wave-V5 and S wave-V1) were measured.&#x0D; Results&#x0D; Patients with depression had a significantly prolonged interval of JTc and small-voltage criterion of the ventricles. Escitalopram significantly improves the prolongation in JTc and non-significantly ameliorate the voltage criterion. There is no significant alteration in the parameter of ejection fraction.&#x0D; Conclusion&#x0D; Irregularities in ECG records were observed in patients with major depressive disorder, and treatment with escitalopram for short period is associated with favorable results rather than negative effects. The evaluation of JTc interval in patients with depression is more suitable than QTc measurement in estimation of the effects of escitalopram.

Study of Electrocardiographic Changes in Patients of Chronic Kidney Disease

Study of Electrocardiographic Changes in Patients of Chronic Kidney Disease

Electrocardiographic changes in patients with raised intracranial pressure from supratentorial brain tumors.

A wide variety of electrocardiographic (ECG) changes has been described in the context of neurological catastrophe. There has been diverse and plentiful literature emphasizing the cardiac changes in acute cerebrovascular events and traumatic brain injury. In stark contrast, there is scarce literature on the incidence of cardiac dysfunction caused by raised intracranial pressure (ICP) resulting from brain tumors. The study aimed to observe the ECG changes concurrent with intracranial hypertension resulting from supratentorial brain tumors. This is a pre-specified subgroup analysis of a prospective and observational study on cardiac function in patients presenting for neurosurgery. Data of 100 consecutive patients of either sex between 18 and 60 years who presented with primary supratentorial brain tumors were analyzed. The patients were divided into two groups: Group 1 consisted of patients without clinical and radiological features of raised ICP and Group 2 consisted of patients with clinical and radiological features of raised ICP. A 12-lead ECG was obtained for every patient on the day before the neurosurgical procedure as part of the pre-anesthetic assessment. The cardiologist and the neuroanesthetist independently examined the ECG, and it was then classified and coded as per the standardized Minnesota code. Statistical analysis was performed with IBM SPSS (release 22.0; IBM Corp., Armonk, NY, USA). The normality of the distribution of continuous variables was tested using the Shapiro-Wilk test. Normally distributed variables were expressed as Mean ± SD. All nominal or categorical variables are described as frequencies and percentages. Categorical variables were compared using the Chi-square test or the Fisher's exact test. The normally distributed continuous variables were compared using Student's t-test. "P < 0.05" was considered statistically significant. About 6% in Group 1 and 32% in Group 2 had abnormal ECG. This was significantly different in Group 2 compared to Group 1 (P < 0.05). No patients in Group 1 had sinus bradycardia, whereas it was observed in 12% of the patients in Group 2 (P = 0.02). ST-segment depression was found in 12% of patients in Group 2, whereas none had it in Group 1 (P = 0.02). ST-segment elevation was noticed in 16 % in Group 2 and 2% in Group 1 (P = 0.01). T-wave abnormalities were found in 16% compared to 4% in Group 1 (P = 0.03). In patients with supratentorial tumors, we observed that those with raised ICP had a higher incidence of ECG changes than those with normal ICP. In addition, repolarization abnormalities and arrhythmias were significantly higher in patients with raised ICP.

Prognostic role of serial electrocardiographic changes in patients with acute pulmonary embolism. Data from the Italian Pulmonary Embolism Registry

BackgroundThe prognostic role of serial electrocardiographic modifications in patients with acute pulmonary embolism (PE) have been poorly investigated. We evaluate the electrocardiographic changes in PE patients during their hospitalization and the prognostic role of such ECG modifications in respect to 30-day mortality in patients enrolled in the Italian Pulmonary Embolism Registry (IPER). MethodsSubjects enrolled into the IPER (September 2006–August 2010) were stratified according to their hemodynamic status, as high- (hemodynamically unstable) and non-high-risk (hemodynamically stable) patients. ECG features were analysed at three fixed time points: at presentation, on day 3 and at discharge. ResultsOverall, 687 patients (286 males, mean age 69.0 ± 15.5 years) were included in the study. Among these, 71 (10.3 %) were at high-risk. In these patients, multivariate analysis revealed that the persistence of right ventricular strain (RVS) after three days from hospitalization was a predictor of 30-day mortality [HRa: 2.78 (95 % CI: 1.05–7.31, p = 0.003)]. Moreover, the persistence of right bundle branch block (RBBB) [HRa: 2. 48 (95 % CI: 1.03–5.09, p = 0.002)], negative T waves in V1-V4 (NTWs) [HRa: 1.63 (95 % CI: 1.04–2.55), p < 0.0001] and qR complex in lead V1 [HRa: HR: 5.44, (95 % CI: 3.22–9.44, p < 0.0001)] were associated with an increased risk of 30-day mortality. When RBBB, NTWs and qR complex in V1 lead were present concomitantly, the 30-day risk of death resulted significantly higher [HR: 12.5 (95 % CI: 3.39–46.4,) p < 0.0001]. ConclusionsPersistence of RBBB, NTWs, and qR pattern in V1 lead at day 3 of hospitalization are independent prognostic factors of death within 30 days in high-risk acute PE patients. The prognostic power of any single ECG abnormality is lower compared to the combination of the three ECG variables.

Case Report: An Unusual Case of Pheochromocytoma

Pheochromocytoma is a benign catecholamine secreting tumor, which is rare and originates from the adrenal gland. It has been known for a wide range of clinical manifestations and can mimic other difficult-to-diagnose diseases. Here, we report a female patient with acquired long QT syndrome, which is a rare complication of pheochromocytoma. Although relatively rare, the presence of pheochromocytoma should be considered in the case of malignant arrhythmias and electrocardiographic changes in patients.

Electrocardiographic changes in patients with COVID-19

Electrocardiography is one of the basic diagnostic tests performed in hospitalized coronavirus disease 2019 (COVID-19) patients. Due to its wide availability and low cost, it is useful in the initial evaluation of COVID-19 patients with a history of cardiovascular disease, and patients with suspected cardiovascular complications in the course of the infection. Electrocardiographic findings seen in COVID-19 patients may include P wave and atrioventricular conduction abnormalities, QRS complex alterations including their fragmentation, evidence of right ventricular overload, ST-T changes, and QTc interval prolongation. The most common cardiac arrhythmias are supraventricular arrhythmias, particularly atrial fibrillation.

Pattern, behavior, and clinical implications of electrocardiographic changes in patients undergoing repair of anomalous aortic origin of coronary arteries

ObjectivesSurgical repair in anomalous aortic origin of a coronary artery aims at mitigating the risk of sudden cardiac death in a subset of patients. The pattern and behavior of electrocardiogram changes in a large cohort of these patients are lacking. We aim to describe postoperative electrocardiogram changes in this population and its clinical implications on follow-up. MethodsAll patients aged less than 21 years who underwent surgical repair for anomalous aortic origin of a coronary artery between December 2012 and June 2020 at our institution were considered for inclusion. Electrocardiograms were reviewed at 5 defined time intervals, from preoperative to 90-day follow-up, with attention to significant findings of ST-segment changes, abnormal T waves, and pathologic Q waves. The electrocardiogram changes were analyzed for correlation with surgical reintervention and medium-term outcomes. ResultsSixty-two patients met inclusion criteria (median age 13.7 years, 61% male). ST-segment changes in the initial postoperative period were seen in 52 patients (84%), all resolving over time. Abnormal T waves were seen in 19 patients (31%), occurred commonly at the predischarge period, and mostly resolved over time. Pathologic Q waves were observed in only 1 patient and associated with reintervention due to coronary artery stenosis. There was no association between postoperative electrocardiogram changes and inducible myocardial ischemia, ventricular dysfunction, or restriction from exercise at follow-up. ConclusionsST-segment changes and T-wave abnormalities are commonly seen in the postoperative period after anomalous aortic origin of a coronary artery repair, tend to resolve over time, and are not associated with adverse medium-term outcomes. Pathologic Q waves were associated with the need for early coronary reintervention.

Prevalence of Electrocardiographic Changes in Patients with Traumatic Brain Injury: A Prospective Hospital-based Study

BACKGROUND: Head trauma and traumatic brain injury (TBI) are major causes of death and disability worldwide. TBI is associated with a variety of electrocardiographic (ECG) changes. AIM: We aimed to evaluate the prevalence of ECG changes in TBI. METHODS: Participants with TBI were included in the study, while participants with chest trauma or cardiovascular diseases were excluded from the study. A consecutive sample of 50 participants (mean age 37.8 ± 14.85 years, 80% males) was selected and referred for 12 lead ECG on admission, 24 h, and 72 h after admission. RESULTS: The prevalence of sinus bradycardia versus sinus tachycardia, short PR interval, ST segment elevation, and inverted T wave in the study population was 18% versus 38%, 26%, 2%, and 16% in ECG on admission, 5% versus 22%, 14%, 0%, and 10% in ECG 24 h after admission, 5% versus 8%, 4%, 0%, and 8% in ECG 72 h after admission, respectively. Serial ECG was significantly associated with changes in heart rate (χ² [1] = 17.337, p = 0.002) and short PR interval (χ² [1] = 9.695, p = 0.008), respectively. There was a significant association between ECG changes and brain edema (χ² [1] = 4.131, p = 0.042), intracerebral hemorrhage (χ² [1] = 4.539, p = 0.033), and subarachnoid hemorrhage groups (χ² [1] = 5.889, p = 0.015), respectively. CONCLUSIONS: ECG changes are prevalent in non-cardiac TBI patients. The significant association of serial ECG with changes in heart rate and short PR interval and the significant association of ECG changes with brain edema, intracerebral hemorrhage, and subarachnoid hemorrhage highlights the potential role of serial ECG as a screening tool for cardiac dysfunction in patients with TBI.

Impact of surgical myectomy on electrocardiographic changes in patients of hypertrophic obstructive cardiomyopathy

Abstract Funding Acknowledgements Type of funding sources: None. Background Hypertrophic cardiomyopathy (HCM) is the commonest genetically inherited cardiac condition affecting 1 in 500 of the population. [1] The amelioration of patient symptomatology and decreased morbidity after surgical myectomy is previously documented. [2]. However, no data is available regarding the associated electrocardiographic changes that may occur after surgical myectomy, especially in patients showed improvement of functional status. Aim of study: The study was conducted to investigate the electrocardiographic changes following surgical myectomy in hypertrophic obstructive cardiomyopathy (HOCM) patients, and its relation to cardiac mechanics Methods The study included 25 patients (mean age: 35.44 ± 12.3 years, 52% male) with HOCM who were subjected to successful surgical myectomy. 12-lead surface ECG and echocardiographic examination including 2D strain imaging were performed pre and post myectomy. Results Postoperatively, 84% of patients developed new complete left bundle branch block (LBBB), 4% developed right BBB (RBBB) and 4% developed complete AV block necessitating permanent pacing. These Changes were associated with increased QRS width and QT interval prolongation in almost all patients (p &amp;lt; 0.001). Following surgery, there was significant reduction in left atrium size, left ventricle mass, LV outflow tract gradient, mitral and annular systolic &amp; diastolic velocities (S’, E’, A’) and EF%(p &amp;lt; 0.001 for all) compared with its preoperative values. At segmental level only LV septal εsys% showed significant inverse correlation to QRS duration (r = 0.47, P &amp;lt; 0.02). No significant correlation was detected between QRS &amp; QTc duration and any other LV wall εsys%. In contrast: QTc intervals showed inverse correlation to the magnitude of reduction in RV εsys %, r=-0.59,P &amp;lt; 0.001 and the magnitude of reduction in RV TTP-SD (r=-.42, P &amp;lt; 0.03). Conclusion Left bundle branch block is a common conduction abnormality after septal myectomy but it did not influence the clinical improvement or structural remodeling. Post myectomy, prolongation of QRS duration was a powerful aspect of mechanical dysfunction especially of septal mechanics than QT interval prolongation. Electrical and mechanical dysfunction is commonly associated while mechanical heterogeneity is not always coexisting.

Evaluation of electrocardiographic changes in patients under COVID-19 treatment regimes

Background and Aim: Awareness of electrocardiographic (ECG) changes is crucial in patients who receive coronavirus disease 2019 (COVID-19) treatment. In this study, we aimed to evaluate ECG parameters in patients under COVID-19 therapy and their relationship with the severity of lung involvement and the disease on the basis of thoracic computerized tomography (TCT) findings and laboratory parameters. Materials and Methods: Of 350 patients hospitalized due to COVID-19 between March 2020 and June 2020, 300 patients with available data were retrospectively analyzed. Blood analysis, electrocardiographic, and clinical findings were evaluated. Six-month follow-up data were also recorded. Results: The patients were categorized into two groups: survivor (n = 206, 68.7%, Group 1) and nonsurvivor patients (n = 94, 31.3%, Group 2). The mean total follow-up period was 125.39 ± 73.09 days. The mean age was similar in both groups. In multivariate regression analysis that aimed to predict COVID-19 disease severity, it was found that besides increased C-reactive protein and D-dimer levels, and ≥50% lung involvement in TCT, which are well known as bad prognostic factors, the corrected QT interval duration (QTc) prolongation ≥60 miliseconds (msn) during hospitalization was associated with worse prognosis in COVID-19 patients during follow-up. Conclusion: Our study is the first study that demonstrated that the presence of ≥60 msn QTc prolongation during hospital stay was found to be the most valuable ECG parameter to predict the prognosis and had a significant association with ≥50% lung involvement in TCT in patients under anti-COVID therapy. Close monitoring of this ECG parameter is important both in terms of treatment planning and interpretation of disease progression.

Study of electrocardiographic changes in patients with acute cerebrovascular accidents

Background: Stroke is “a focal (or at times global) neurological impairment of sudden onset, and lasting more than 24 hours (or leading to death), and of presumed vascular origin. A variety of cardiovascular events like cardiac arrest, arrhythmias, and severe hypotension can be seen in stroke victims. The purpose of this study is to investigate the prevalence and characterization of ECG abnormalities in patients of cerebrovascular accidents.Methods: Study was carried out in Dr. PDMMC and tertiary care hospital Amravati, Maharashtra, India. All acute cerebrovascular accidents patients were the study subjects. The diagnosis of ischemic stroke was confirmed by CT scanning. Pre-validated questionnaire was used for data collection. At the end of the study all the ECG were compared to approach towards the result. Study was carried out over a period of three months from October to December 2020.Results: We have recruited 90 stroke patients, most of them were males. Major type was ischemic stroke. In total 62 (68.89%) stroke patients had some form of ECG change. Majority i.e. 35 (38.89%) patients had QTc prolongation followed by 32 (35.56%) patients had T wave changes. QTc prolongation and Atrial fibrillation were significantly more among hemorrhagic stroke patients (p&lt;0.05) and T wave changes and ST changes (elevation or depression) were significantly more among ischemic stroke patients (p&lt;0.05).Conclusions: Prevalence of ECG abnormalities among stroke patients was more i.e. 68.89%. QTc prolongation and T wave changes were the commonest ECG abnormalities.

Impact of cardiac rehabilitation on ventricular repolarization indices following coronary artery bypass grafting.

Background The aim of this study was to evaluate the effect of cardiac rehabilitation on electrocardiographic changes in patients undergoing isolated coronary artery bypass grafting. Methods Between January 2016 and July 2019, a total of 625 patients (485 males, 140 females; mean age: 59.6 years; range, 50.6 to 68.6 years) who underwent isolated coronary artery bypass grafting and survived were retrospectively analyzed. The patients were divided into two groups according to the participation in the cardiac rehabilitation program as follows: the Rehab(+) group (n=363) and the Rehab(-) group (n=262). Electrocardiographic parameters of both groups were compared. Results There was a significant decrease in the electrocardiographic findings of heart rate (p<0.001), QTc (p<0.001), Tpe duration (p<0.001), Tpe/QT ratio (p<0.001), and Tpe/QTc ratio (p<0.001) in the Rehab(+) group before and after surgery. There was a significant decrease in the Rehab(+) group, compared to the Rehab(-) group, in terms of parameters of QT interval (p=0.001), QTc (p=0.017), Tpe duration (p<0.001), Tpe/QT ratio (p<0.001), and Tpe/QTc ratio (p<0.001). Conclusion Cardiac rehabilitation program after coronary artery bypass grafting decreases ventricular repolarization indices of electrocardiography. Based on these changes, postoperative cardiac rehabilitation program may reduce the risk of ventricular arrhythmia and sudden cardiac death during follow-up.

Abstract 16051: Pattern and Behavior of Electrocardiographic Changes in Patients Undergoing Repair of Anomalous Aortic Origin of Coronary Arteries

Introduction: Surgical repair in anomalous aortic origin of a coronary artery (AAOCA) aims at mitigating the risk of sudden cardiac death in a subset of patients (pts). The pattern and behavior of electrocardiogram (ECG) changes in a large cohort of these pts is lacking. We aim to describe post-operative (post-op) ECG changes in this population with medium term follow up (f/u). Methods: Observational study evaluating ECGs before and after surgery to describe peri-operative changes through f/u. All patients &lt;21 years (yrs) with AAOCA were prospectively evaluated and managed following a standardized approach from 12/2012-11/2019. A subset underwent repair given high-risk features. ECGs were reviewed at 5 specific time intervals from pre-operative (pre-op) to 90-day post-op f/u. Significant findings included new ST elevation (STE), T wave inversion (TWI) and/or new q waves. Results: A total of 64 pts were identified (median age 13.7 yrs, 64% male). Two patients had evidence of STE and TWI pre-op and were not included. Of 62 pts: 47 (75%) had new STE early post-op and all but 1 had resolution at 90-day f/u; 50 (81%) had no evidence of new TWI or q waves early post-op and 96% of these remained stable at 90-day f/u. Conversely, 12 (19%) had new TWI in the early post-op: 8 had isolated changes (75% resolved at 90 days) and 4 associated with new q waves (50% resolved at 90 days). Including all ECG changes in the total cohort, 92% resolved completely at 90-day f/u. In those pts (8%) with persistent changes, none required late reintervention and all but 1 were cleared for return to exercise. All patients were alive at medium f/u of 4 yrs (IQR 2-6) with normal ventricular function. Conclusions: New STE is a common finding in the early post-op period following repair of AAOCA and is not correlated with persistent ECG changes at 90-day follow up. TWI is infrequently seen but less likely to resolve if associated with new q waves. Despite these changes in the early post-op, clinical outcomes medium-term are excellent.