Evaluation of Heart Rate Variability in Children with Congenital Heart Diseases before and after Surgical Repair

Background: Surgical repair of congenital heart diseases (CHD) affects heart rate variability (HRV) in different ways. It leads to varying degrees of cardiac autonomic derangement, clinically detectable as depression of HRV parameters. The aim of this work was to evaluate HRV in children with CHDs before and after surgical repair to detect the effect of CHDs (acyanotic or cyanotic) and cardiac surgery on cardiac autonomic function.

Methods: This observational case-control study enrolled thirty cases with CHD. Cases were divided in two equal groups: group1 included children with CHDs (not repaired) before surgical intervention and group 2 included children after surgical repair of CHDs. Another fifteen healthy children, matched for age and sex, were enrolled as a control group. All children in this study were subjected to full history taking, clinical evaluation, Holter monitor, twenty-four-hour ambulatory electrocardiographic recordings and the seven time-domain indices of HRV.

Results: There was significant increase of HR in patients before surgical repair as compared to patients after surgical repair as compared to control group. There was significant decrease of PNN50, r MMSD, SDNN index and SDANN of children before surgical repair as compared to children after surgical repair as compared to controls. There was a negative significant correlation between HR and age before surgery, after surgery there was a negative significant correlation between HR and age, pNN50, rMMSD, SDNN index and SDANN, in control there was negative significant correlation with age, SDNN index, SDANN and SDNN.

Conclusion: HRV parameters increased significantly in children with CHDs after surgical repair as compared to these before surgical repair denoting effect of cardiac surgery on cardiac autonomic function.