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Heart Rate Variability in Children With Fontan Circulation: Lateral Tunnel and Extracardiac Conduit

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Abstract

The technique in Fontan surgery has developed from the lateral tunnel (LT) toward the extracardiac conduit (EC) used to reduce long-term complications such as atrial arrhythmia and sinus node dysfunction. Heart rate variability (HRV) examines cardiac nervous activity controlling the sinus node. This study aimed to investigate HRV in a cohort of children with univentricular hearts, focusing on the relation between HRV and surgical procedure. For 112 children with Fontan circulation, HRV was analyzed using power spectral analysis. Spectral power was determined in three regions: very-low-frequency (VLF), low-frequency (LF), and high-frequency (HF) regions. Patients were compared with 66 healthy controls subject. Patients with LT were compared with patients who had EC. The children with Fontan circulation showed a significantly reduced HRV including total power (P < 0.0001), VLF (P < 0.0001), LF (P < 0.0001), and HF (P = 0.001) compared with the control subjects. The LT and EC patients did not differ significantly. Reduced HRV was found in both the LT and EC patients. In terms of HRV reduction, EC was not superior to LT.

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Acknowledgment

This study was funded by the Swedish Heart-Lung Foundation according to the Agreement on Medical Education and Research, Västerbotten County Council, Sweden.

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Authors and Affiliations

  1. Department of Clinical Sciences, Umeå University, 901 85, Umeå, Sweden

    Jenny Alenius Dahlqvist & Annika Rydberg

  2. Department of Biomedical Engineering and Informatics, Umeå University, 901 85, Umeå, Sweden

    Marcus Karlsson & Urban Wiklund

  3. Department of Surgical and Perioperative Science, Clinical Physiology, Umeå University, 901 85, Umeå, Sweden

    Rolf Hörnsten

  4. Division of Cardiology, Department of Paediatrics, Sahlgrenska University Hospital/Queen Silvia Children’s Hospital, Göteborg University, Göteborg, 416 85, Sweden

    Eva Strömvall-Larsson

  5. Department of Cardiothoracic Surgery, Sahlgrenska University Hospital/Queen Silvia Children’s Hospital, Göteborg University, Göteborg, 416 85, Sweden

    Håkan Berggren

  6. Department of Paediatrics, Children’s Hospital, Lund University Hospital, Lund, 221 85, Sweden

    Katarina Hanseus

  7. Paediatric Cardiac Surgical Unit, Children’s Hospital, Lund University Hospital, Lund, 221 85, Sweden

    Sune Johansson

Authors
  1. Jenny Alenius Dahlqvist
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  2. Marcus Karlsson
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  3. Urban Wiklund
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  7. Katarina Hanseus
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  8. Sune Johansson
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  9. Annika Rydberg
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Correspondence to Annika Rydberg.

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Dahlqvist, J.A., Karlsson, M., Wiklund, U. et al. Heart Rate Variability in Children With Fontan Circulation: Lateral Tunnel and Extracardiac Conduit. Pediatr Cardiol 33, 307–315 (2012). https://doi.org/10.1007/s00246-011-0126-2

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  • DOI: https://doi.org/10.1007/s00246-011-0126-2

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