Prognostic significance of the absence of normal septal Q waves before aortic valve replacement

J Electrocardiol. 2013 Jul-Aug;46(4):368-74. doi: 10.1016/j.jelectrocard.2013.02.003. Epub 2013 Mar 15.

Abstract

Purpose: Aim of this study was to investigate the prognostic significance of absence of septal Q waves in patients scheduled for aortic valve replacement.

Material and methods: Sixty-one patients who underwent isolated aortic valve replacement for aortic stenosis were retrospectively evaluated. Septal Q waves were defined as Q waves of<2mm in amplitude and<40ms in width and absence of septal Q waves was defined as simultaneous loss of Q waves from at least three of the leads I, aVL, V5 and V6. Septal Q waves were absent in 17 patients (Group AQ, 27.8%) and were present in 44 patients (Group PQ, 72.1 %) preoperatively. Newly developed AV block>1st degree and newly developed left bundle branch block were primary endpoints.

Results: Preoperatively, absence of normal septal Q waves was significantly associated with increased risk of postoperative AV block (HR: 11.18, range 1.37-91.21, 95% CI, p=0.02) whereas it was not associated with increased risk for newly developed LBBB (HR: 3.15 0.62-15.83, 95% CI, p=0.16).

Conclusion: Absence of normal septal Q waves in the preoperative ECG may predict further delay in conduction which might develop in the early postoperative course of aortic valve replacement.

Publication types

  • Comparative Study

MeSH terms

  • Aortic Valve Stenosis / diagnosis*
  • Aortic Valve Stenosis / epidemiology
  • Aortic Valve Stenosis / surgery*
  • Atrioventricular Block / diagnosis*
  • Atrioventricular Block / epidemiology
  • Bundle-Branch Block / diagnosis*
  • Bundle-Branch Block / epidemiology
  • Comorbidity
  • Electrocardiography / statistics & numerical data*
  • Female
  • Heart Valve Prosthesis Implantation
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / epidemiology
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Turkey / epidemiology