The Effect of Transcatheter Ventricular Septal Defect Closure on Heart Rate Variability Parameters

Kayseri City Hospital37 enrolled

Overview

In this study; we evaluated the heart rate variability parameters of pediatric patients whose VSDs were closed with the transcatheter method before and after, and compared with the control group.

Heart rate variability (HRV) is a sign of cardiac autonomic nervous system. Evaluation of HRV in pediatric ventricular septal defect (VSD) cases before and after transcatheter closure will enlighten us in terms of cardiac autonomic control. Methods: 19 VSD cases treated with transcatheter closure method and 18 healthy children were enrolled in the study. 24 hours Holter rhythm monitorization was applied to all patients before closure of VSD and to the control group. In the patient group, Holter rhythm monitorization was repeated in the third months. HRV parameters were obtained from Cardio Scan Premier 12® program. Frequency domain (Total power, VLF, LF, HF, LF/HF ratio) and time domain analysis (SDNN, SDANN, SDNNi, pNN50, rMSSD) were applied.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Ventricular Septal Defect Closure; Interventricular Septum Autonomic Nervous System Imbalance

Interventions

24 hours ambulatory Holter monitoringDIAGNOSTIC_TEST

Eligibility

Sex: ALLMin age: 56 MonthsMax age: 136 MonthsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * VSD diameter \<6mm * Significant left-to-right shunt * Left atrial and ventricular enlargement detected by echocardiography or calculation of Qp/Qs ratio above 1.5 in the catheterization laboratory (Qp/Qs\>1.5) Exclusion Criteria: * Patients with arrhythmia after the procedure * Young patients who may be inconsistent during Holter records

Locations (1)

Süleyman Sunkak

Kayseri, Kocasinan, Turkey (Türkiye)

Outcomes

Primary Outcomes

Heart rate variability parameters

Time Domain analysis: After ectopic beats and artifacts were excluded, the following indices were calculated for time domian analysis in the whole Holter recording. * SDNN: Standard deviation of all filtered RR intervals * SDANN: Standard deviation of 5-minute averages of RR intervals * SDNNindex: Mean of the standard deviation of all RR intervals for all the 5-minute segments * rMSSD: Square root of the mean of the sum of square differences between adjacent filtered RR interval * PNN50: Percentage of the difference between adjacent RR intervals greater than 50 milliseconds Frequency domain analysis: We determined spectral power over three frequency. * Very low frequency (VLF) index (0.003-0.04 Hz) * Low frequency (LF) index (0.04 - 0.15 Hz) * High frequency (HF) index (0.15 - 0.40 Hz) * Total power: Variance of all NN intervals approximately \<0.4 Hz

Time frame: 24 hours

Data from ClinicalTrials.gov

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