Literature DB >> 17382623

Risk factors for cardiac arrhythmias in children with congenital heart disease after surgical intervention in the early postoperative period.

Joanna Rekawek1, Andrzej Kansy, Maria Miszczak-Knecht, Małgorzata Manowska, Katarzyna Bieganowska, Monika Brzezinska-Paszke, Elzbieta Szymaniak, Anna Turska-Kmieć, Przemysław Maruszewski, Piotr Burczyński, Wanda Kawalec.   

Abstract

OBJECTIVE: Early postoperative arrhythmias are a recognized complication of pediatric cardiac surgery.
METHODS: Diagnosis and treatment of early postoperative arrhythmias were prospectively analyzed in 402 consecutive patients aged 1 day to 18 years (mean 29.5 months) who underwent operation between January and December 2005 at our institute. All children were admitted to the intensive care unit, and continuous electrocardiogram monitoring was performed. Risk factors, such as age, weight, Aristotle Basic Score, cardiopulmonary bypass time, aortic crossclamp time, and use of deep hypothermia and circulatory arrest, were compared. Statistical analysis using the Student t test, Mann-Whitney U test, or Fisher exact test was performed. Multivariate stepwise logistic regression was used to assess the risk factors of postoperative arrhythmias.
RESULTS: Arrhythmias occurred in 57 of 402 patients (14.2%). The most common types of arrhythmia were junctional ectopic tachycardia (21), supraventricular tachycardia (15), and arteriovenous block (6). Risk factors for arrhythmias, such as lower age (P = .0041*), lower body weight (P = .000001*), higher Aristotle Basic Score (P = .000001*), longer cardiopulmonary bypass time (P = .000001*), aortic crossclamp time (P = .000001*), and use of deep hypothermia and circulatory arrest (P = .0188*), were identified in a univariate analysis. In the multivariate stepwise logistic regression, only higher Aristotle Basic Score was statistically significant (P = .000003*) compared with weight (P = .62) and age (P = .40); in the cardiopulmonary bypass group, only longer aortic crossclamp time was statistically significant (P = .007*).
CONCLUSION: Lower age, lower body weight, higher Aristotle Basic Score, longer cardiopulmonary bypass time, aortic crossclamp time, and use of deep hypothermia and circulatory arrest are the risk factors for postoperative arrhythmias. Junctional ectopic tachycardia and supraventricular tachycardia were the most common postoperative arrhythmias.

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Year:  2007        PMID: 17382623     DOI: 10.1016/j.jtcvs.2006.12.011

Source DB:  PubMed          Journal:  J Thorac Cardiovasc Surg        ISSN: 0022-5223            Impact factor:   5.209


  32 in total

Review 1.  The changing epidemiology of congenital heart disease.

Authors:  Teun van der Bom; A Carla Zomer; Aeilko H Zwinderman; Folkert J Meijboom; Berto J Bouma; Barbara J M Mulder
Journal:  Nat Rev Cardiol       Date:  2010-11-02       Impact factor: 32.419

2.  Epidemiology of arrhythmias in children.

Authors:  R Prem Sekar
Journal:  Indian Pacing Electrophysiol J       Date:  2008-05-01

3.  Predictors of Extended Length of Hospital Stay Following Surgical Repair of Congenital Heart Diseases.

Authors:  Ahmad Saeed Azhar; Hasan Mohamed Aljefri
Journal:  Pediatr Cardiol       Date:  2018-08-31       Impact factor: 1.655

4.  Risk Factors for Development of Ectopic Atrial Tachycardia in Post-operative Congenital Heart Disease.

Authors:  Bradley C Clark; John T Berger; Charles I Berul; Richard A Jonas; Jonathan R Kaltman; Julianne Lapsa; Dilip S Nath; Elizabeth D Sherwin; Pranava Sinha; David Zurakowski; Jeffrey P Moak
Journal:  Pediatr Cardiol       Date:  2017-11-17       Impact factor: 1.655

5.  Junctional ectopic tachycardia.

Authors:  Johnson Francis
Journal:  Indian Pacing Electrophysiol J       Date:  2010-07-20

6.  A genetic contribution to risk for postoperative junctional ectopic tachycardia in children undergoing surgery for congenital heart disease.

Authors:  Kristie Y Borgman; Andrew H Smith; Jill P Owen; Frank A Fish; Prince J Kannankeril
Journal:  Heart Rhythm       Date:  2011-07-06       Impact factor: 6.343

7.  Post operative temporary epicardial pacing: When, how and why?

Authors:  Anjan S Batra; Seshadri Balaji
Journal:  Ann Pediatr Cardiol       Date:  2008-07

Review 8.  Magnesium supplementation reduces postoperative arrhythmias after cardiopulmonary bypass in pediatrics: a metaanalysis of randomized controlled trials.

Authors:  Hee Young Lee; Saurav Ghimire; Eun Young Kim
Journal:  Pediatr Cardiol       Date:  2013-02-27       Impact factor: 1.655

9.  Management of postoperative pediatric cardiac arrhythmias: current state of the art.

Authors:  Jennifer N A Silva; George Van Hare
Journal:  Curr Treat Options Cardiovasc Med       Date:  2009-10

10.  Cardiac arrhythmias in congenital heart diseases.

Authors:  Paul Khairy; Seshadri Balaji
Journal:  Indian Pacing Electrophysiol J       Date:  2009-11-01
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