ArticleFrontiers in pediatrics2024
Development of right ventricular electromechanical dyssynchrony following surgical repair of tetralogy of Fallot in infants.
Article in Frontiers in pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Dyssynchrony-Induced Cardiomyopathy in Children: Mechanisms, Diagnosis, and Contemporary Management.Pediatric cardiology · 2026Review
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: In adolescents and adults with tetralogy of Fallot (TOF), right ventricle (RV) electromechanical dyssynchrony (EMD) due to right bundle branch block (RBBB) is associated with reduced exercise capacity and RV dysfunction. While the development of RBBB following surgical repair of tetralogy of Fallot (rTOF) is a frequent sequela, it is not known whether EMD is present in every patient immediately following rTOF. The specific timing of the onset of RBBB following rTOF therefore provides an opportunity to assess whether acute RBBB is associated with the simultaneous acquisition of EMD. Methods: Transthoracic echocardiography with speckle tracking analysis for RV global longitudinal strain (GLS) and 12-lead ECG were performed prospectively on 20 infants following rTOF. Three apical RV views were obtained using analogous imaging planes to the standard LV views to provide a comprehensive evaluation. Regional RV GLS patterns were categorized as synchronous, EMD, or indeterminate. EMD was defined as an early-terminated septal contraction opposed by early stretch and post-systolic peak contraction in the activation delayed RV free wall. An indeterminate pattern was defined as a lack of fully synchronous contraction of all segments but not meeting criteria for EMD. Pre-rTOF echocardiograms and ECGs were analyzed to confirm the presence of synchronous contraction and a normal QRS pattern and duration prior to surgery. Results: Twenty TOF infants (median age 87 days; 8 days from surgery to post-rTOF evaluation) demonstrated QRSd prolongation following rTOF (pre-rTOF 58 ± 9 ms; post-rTOF 97 ± 14 ms; Discussion: Acquisition of acute QRS prolongation in a RBBB pattern is near-universal following rTOF but without matched or identical patterns of dyssynchrony, suggesting that variations in the time from electrical to electromechanical dyssynchrony potentially caused by differences in right bundle branch anatomy and injury may be relevant to electromechanical outcomes.
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