Examining the Correlation Between the GOSE Index and Atrial Arrhythmia Development with Electrocardiographic P-wave Properties in Patients with Ebstein’s Anomaly

Abstract

Introduction: Ebstein's anomaly (EA) is a congenital malformation of the tricuspid valve. In the present study, the aim was to examine the relationship between the Great Ormond Street Score (GOSE) index and P-wave characteristics in patients with EA. Patients and Methods: Unoperated patients with EA were evaluated retrospectively. Echocardiographic GOSE indices were calculated for each patient. The P-wave characteristics on the 12-channel electrocardiography (ECG) were also evaluated simultaneously. Results: There were EA 24 cases in the study. The median age was 12 months (range, 1 day-8 years). The median P-wave dispersion was 18 msn (range, 8-36 msn), median P-max duration was 86 msn (range, 58-104 msn), median P-min duration was 62 ms (range, 18-88 msn), and median P amplitude was 2.7 mm (range, 1.2-5 mm). Atrial arrhythmia was detected in eight cases. In the arrhythmia group, the P dispersion and P-max duration were significantly higher than in the non-arrhythmic group (p< 0.05). The median GOSE index was measured as 0.62 (range, 0.2-1.3). The GOSE index grade was detected as Grade 1 in 8 cases, Grade 2 in 12 cases, and Grade 3 in 4 cases. When the patients' GOSE index and P-wave characteristics were evaluated, a positive correlation was found between the P-max (r= 0.5, p= 0.02) and P amplitude (r= 0.780, p= 0.001). There was no significant correlation between the P dispersion and P-min durations (p> 0.05). Conclusion: In EA cases, the GOSE index can be estimated, especially by evaluating the P-wave maximum duration and amplitude. Thus, clinicians may have an idea about the prognosis of cases with EA by evaluating the P-wave changes in ECG and especially the development of supraventricular arrhythmia.