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Arrhythmia in early post cardiac surgery in pediatrics: Siriraj experience

Kanoknaphat Chaiyarak1, Jarupim Soongswang, Kritvikrom Durongpisitkul

  • 1Her Majesty Cardiac Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|June 18, 2008
PubMed

Insights

Early postoperative arrhythmias are common in pediatric open-heart surgery patients. Longer cardiopulmonary bypass times and repeat surgeries increase the risk of these arrhythmias, impacting patient outcomes.

Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Postoperative arrhythmias are a significant concern in pediatric cardiac surgery.
  • Understanding their incidence and risk factors is crucial for improving patient care.

Purpose of the Study:

  • To determine the incidence, risk factors, and outcomes of early postoperative arrhythmias in pediatric patients with congenital heart disease.
  • To identify specific surgical and patient characteristics associated with increased arrhythmia risk.

Main Methods:

  • Prospective study of pediatric patients undergoing open-heart surgery.
  • Data collection included demographics, diagnoses, pre-operative arrhythmias, surgical details, and continuous postoperative electrocardiographic monitoring.
  • Analysis of arrhythmia types, timing, and associated risk factors.

Main Results:

  • 23.5% of 191 pediatric patients developed early postoperative arrhythmias, primarily within 24 hours.
  • Junctional ectopic tachycardia (40%) and heart block (15.6%) were the most common arrhythmias.
  • Single ventricle physiology repair, longer cardiopulmonary bypass times, and redo-operations were identified as significant risk factors.

Conclusions:

  • Postoperative arrhythmias are common and critical complications following pediatric open-heart surgery.
  • Prolonged cardiopulmonary bypass and redo-operations are key risk factors for early arrhythmias.
  • Effective management strategies are essential to mitigate the impact of these arrhythmias on patient outcomes.
Abstract

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