Electromechanical remodelling in children with secundum atrial septal defect

Background Atrial septal defect (ASD) secundum is a prevalent congenital heart defect that can cause right-sided volume overload, leading to mechanical and electrical remodeling. Aim The study was to detect the mechanical effects of ASD on the Rt side of the heart of such children by echocardiogram and electrical remodeling effects of ASD secundum in the form of ECG changes and incidence of arrhythmia by ECG changes in such children. Patients and methods This cross-sectional study was conducted over a 1-year duration. It included 60 children in the pediatric age. They were classified into 30 children with ASD secundum and 30 healthy youngsters, stratified by age and sex as a control cohort. We conducted a thorough clinical evaluation and took a complete history. Echocardiographic assessment was performed to assess right atrium (RA) and right ventricle dimensions and functions by conventional echo and tissue Doppler imaging. Electrocardiographic evaluation was done using 12-lead ECG and 24 h Holter monitoring to detect ECG changes and type of arrhythmia if present. Results The results showed that RA size and mechanical functions were significantly affected in cases with ASD secundum. Incidence of RA and right ventricle dilatation was notably elevated in cases of ASD secundum. Incidence of arrhythmia was markedly elevated in cases of ASD secundum. Larger ASD size and older age were significantly related to higher incidence of arrythmia in patients with ASD secundum. Conclusion Secundum ASD can cause mechanical and electrical changing of right side of the heart. Incidence of arrythmia was higher in cases of ASD secundum in the form of supraventricular arrythmia or bradyarrhythmia.