Increased microvolt T-wave alternans in children and adolescents with Eisenmenger syndrome

Objective: To determine the values of microvolt T-wave alternans (MTWA) in children and adolescents with Eisenmenger syndrome (ES) and controls. Methods: Thirteen were included in the study. After analyzing the 24-h ECG recordings, MTWA was considered using three leads (V5, V1, and aVF). Right heart catheterization and 6-minute walk test (6-MWD) were applied to the patients and pro-brain natriuretic peptide levels were assessed; echocardiographic parameters were obtained from both the groups and the results were compared. Results: The MTWA value in lead V5 was 81.08 +/- 10.73 mu V in the patient group (63.50 +/- 18.78 mu V in the control group), in lead V1 was 75.00 +/- 16.86 mu V (73.94 +/- 16.77 mu V in the control group), and in lead aVF was 73.77 +/- 17.81 mu V (72.61 +/- 16.21 mu V in the control group). Comparison of MTWA values between patients and controls revealed that only lead V5 values were statistically different in the ES group. The 6-MWD scores significantly correlated with lead V5. Right atrial volume and right ventricular fractional area change were significantly correlated with lead V1. The Tei index was significantly correlated with lead aVF. Conclusion: The MTWA lead V5 value was significantly higher in children with ES than in controls and was also correlated with decreased exercise tolerance.