Early postoperative arrhythmias after pediatric cardiac surgery.

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.

• Authors: Sachin Talwar, Kartik Patel, Rajnish Juneja, Shiv Kumar Choudhary, Balram Airan
• Journal: Asian cardiovascular & thoracic annals (Asian Cardiovasc Thorac Ann) Vol. 23 Issue 7 Pg. 795-801 (Sep 2015) ISSN: 1816-5370 [Electronic] England
• PMID: 25972292 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2015.

Topics

• Adolescent
• Arrhythmias, Cardiac (diagnosis, epidemiology, etiology)
• Cardiac Surgical Procedures (adverse effects, methods)
• Cardiopulmonary Bypass (adverse effects, methods)
• Child
• Child, Preschool
• Heart Defects, Congenital (epidemiology, surgery)
• Humans
• Incidence
• India (epidemiology)
• Infant
• Postoperative Complications (diagnosis, epidemiology)
• Prospective Studies
• Risk Factors
• Time-to-Treatment
• Treatment Outcome