Use of atrial epicardial electrodes to diagnose and treat postoperative arrhythmias in children.

Temporary Teflon-coated stainless steel wires were placed on the right atrium of 100 consecutive infants and children undergoing open heart surgery. The patients' ages ranged from 1 day to 17 years. The wires were used for diagnosis or treatment 40 times in 30 patients. Atrial electrograms were recorded 14 times to diagnose arrhythmias and conduction disturbances that were unsuspected or misdiagnosed from the standard electrocardiogram. In 10 patients, atrial pacing was used to treat postoperative arrhythmias. Atrial pacing was also used as an adjunct to therapy in 16 children with postoperative low cardiac output and bradycardia with intact atrioventricular conduction. The wires were removed before discharge and no complications resulted from their use. Previous studies have demonstrated the usefulness of temporary atrial wires after cardiac surgery in adults. This experience confirms that the technique is easy and safe and can be of great diagnostic and therapeutic value in children.