Sachin Talwar1, Kartik Patel2, Rajnish Juneja2, Shiv Kumar Choudhary2, Balram Airan2. 1. Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India sachintalwar@hotmail.com. 2. Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.
Abstract
BACKGROUND: This prospective study proposed to determine the incidence, risk factors, and management protocols for early postoperative arrhythmias after pediatric cardiac surgery, with focus on outcomes, using a uniform protocol, and also to see if children operated on at a later age have different issues from those operated on earlier. METHODS: Of 224 consecutive pediatric patients undergoing cardiac surgery from September 2013 to July 2014, 24 were excluded because their procedures were performed without cardiopulmonary bypass. RESULTS: The median age was 24 months (mean 50.1 ± 62.4 months, range 0.5-216 months). Fifteen (7.5%) patients developed arrhythmia, the most common was junctional ectopic tachycardia (n = 7, 46.6%) followed by supraventricular tachycardia (n = 5, 33.3%). All junctional ectopic tachycardias occurred within 24 h of intensive care unit admission. Of the 7 patients with junctional ectopic tachycardia, 5 responded to conventional measures and 2 required amiodarone infusion. There was a significant longer cardiopulmonary bypass time in patients with arrhythmias compared to those without arrhythmias. CONCLUSION: We observed a very low incidence of arrhythmias, particularly junctional ectopic tachycardia, after open heart surgery in children. Other than a longer cardiopulmonary bypass time, no specific predictors were identified. It appears that the cause of arrhythmias following pediatric cardiac surgery is multifactorial and needs further study with a greater number of patients.
BACKGROUND: This prospective study proposed to determine the incidence, risk factors, and management protocols for early postoperative arrhythmias after pediatric cardiac surgery, with focus on outcomes, using a uniform protocol, and also to see if children operated on at a later age have different issues from those operated on earlier. METHODS: Of 224 consecutive pediatric patients undergoing cardiac surgery from September 2013 to July 2014, 24 were excluded because their procedures were performed without cardiopulmonary bypass. RESULTS: The median age was 24 months (mean 50.1 ± 62.4 months, range 0.5-216 months). Fifteen (7.5%) patients developed arrhythmia, the most common was junctional ectopic tachycardia (n = 7, 46.6%) followed by supraventricular tachycardia (n = 5, 33.3%). All junctional ectopic tachycardias occurred within 24 h of intensive care unit admission. Of the 7 patients with junctional ectopic tachycardia, 5 responded to conventional measures and 2 required amiodarone infusion. There was a significant longer cardiopulmonary bypass time in patients with arrhythmias compared to those without arrhythmias. CONCLUSION: We observed a very low incidence of arrhythmias, particularly junctional ectopic tachycardia, after open heart surgery in children. Other than a longer cardiopulmonary bypass time, no specific predictors were identified. It appears that the cause of arrhythmias following pediatric cardiac surgery is multifactorial and needs further study with a greater number of patients.
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
Authors: Mohamed Fouad Ismail; Amr A Arafat; Tamer E Hamouda; Amira Esmat El Tantawy; Azzahra Edrees; Abdulbadee Bogis; Nashwa Badawy; Alaa B Mahmoud; Ahmed Farid Elmahrouk; Ahmed A Jamjoom Journal: J Cardiothorac Surg Date: 2018-06-05 Impact factor: 1.637