AIM To explore the clinical significance of P-wave variability (Pw-d) and QT variability (QTd) in the diagnosis and treatment of perioperative arrhythmia in children with congenital heart disease combined with pulmonary artery hypertension(PAH) at high altitude area.
METHODS From December 2013 to December 2018, 30 children with congenital heart disease combined with pulmonary hypertension from plateau area were selected as group A, 30 children with congenital heart disease without pulmonary hypertension as group B, and 30 children in department of pediatric of our hospital (without congenital heart disease) as control group. The Pw-d and QT-d of each patient were measured by electrocardiogram（ECG）. If arrhythmia is detected by ECG monitoring, 24-hour ECG monitoring was done to confirm the existence and the type of arrhythmia.
RESULTS The average length of QT, QT-d, P-mean time, Pw-d, and heart rate in group A were significantly higher than those in group B and C. There was no significant correlation between Pw-d or QT-d and EF in group A. However, significant positive correlation was observed between Pw-d or QT-d with MPAP and RVD (P < 0.05). 24-hour ECG showed that 10 patients in group A had arrhythmia, while 6 patients in group B and C had supraventricular tachycardia, 2 patients with atrial flutter (7%) and 2 patients with atrial fibrillation (7%). The average lengths of QT, QT-d and Pw-d in patients with arrhythmia were significantly higher than those in patients without arrhythmia (P < 0.05).
CONCLUSION Pw-d and QT-d have important clinical predictive significance for the diagnosis and treatment of various arrhythmias in children from highaltitudearea with congenital heart disease complicated with PAH preoperatively.
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