Arrhythmia in early post cardiac surgery in pediatrics: Siriraj experience
Chaiyarak, K.; Soongswang, J.; Durongpisitkul, K.; Laohaprasitiporn, D.; Chanthong, P.; Nana, A.; Sriyodcharti, S.; Subtaweesin, T.; Prakanrattana, U.
Journal of the Medical Association of Thailand 91(4): 507-514
2008
ISSN/ISBN: 0125-2208 PMID: 18556860 Document Number: 3375
Objectives: To determine the incidence, risk factors and outcome of early postoperative arrhythmias in pediatric patients with congenital heart disease.Material and Method: A prospective study was conducted in every pediatric patient who consecutively underwent open-heart surgery at Siriraj Hospital from January 1(st) to December 31(st), 2006. The collected data were demographic data, diagnosis, pre-operative arrhythmia, cardiac surgical data and continuous electro-cardiographic monitoring data throughout the post operative intensive care period.Results: A total of 191 pediatric patients underwent cardiac surgery Forty-five cases (23.5%) developed early post operative cardiac arrhythmias i.e. junctional ectopic tachycardia 18 cases (40%), heart block 7 cases (15.6%), supraventricular tachycardia 2 cases (4.4%). Cardiac arrhythmia occurred mostly within 24 hours after the operation. Patients with single ventricle physiology repaired developed the highest incidence of acute post operative arrhythmia (36.4%). Longer cardiopulmonary bypass time; and redo-operation were the risk factors. Thirty-nine cases were treated with medications, 7 cases with temporary pacing, and I case with electrical cardioversion. Four patients needed long-term anti-arrhythmic agents. Cardiac arrhythmia played role in the causes of death in 2 cases (1.1% of total cases).Conclusions: Post operative arrhythmias remained common and important complications of pediatric open-heart surgery. Long cardiopulmonary bypass time and redo-operation were risk factors for early post operative arrhythmia.
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