Early postoperative arrhythmias after pediatric cardiac surgery

Asian Cardiovasc Thorac Ann. 2015 Sep;23(7):795-801. doi: 10.1177/0218492315585457. Epub 2015 May 12.

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.

Keywords: Arrhythmias; Child; Heart defects; Postoperative complications; Tachycardia; cardiac; congenital.

MeSH terms

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