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Arrhythmia during diagnostic cardiac catheterization in pediatric patients with congenital heart disease
Taner Kasar, İbrahim Cansaran Tanıdır1, Erkut Öztürk
1Department of Pediatric Cardiology, University of Health Sciences, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey. cansaran@yahoo.com.
Insights
Arrhythmia occurs in 7% of pediatric cardiac catheterizations for congenital heart disease. Prompt management of these arrhythmias is crucial for reducing complications and improving patient outcomes.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Cardiac Electrophysiology
Background:
- Cardiac catheterization for congenital heart disease (CHD) is increasingly common.
- Arrhythmia is a known complication during these procedures.
Purpose of the Study:
- To evaluate the incidence and causes of arrhythmia during cardiac catheterization in children with CHD.
- To assess treatment strategies for catheterization-related arrhythmias.
Main Methods:
- Retrospective analysis of cardiac catheterization data from 1316 children with CHD (2012-2018).
- Categorization of arrhythmias by type (bradyarrhythmia, tachyarrhythmia) and severity.
- Review of therapeutic interventions and outcomes.
Main Results:
- Arrhythmia developed in 7% (93/1316) of patients.
- Bradyarrhythmia (62%) was more common than tachyarrhythmia (38%).
- 61% of arrhythmias required treatment, including pharmacological therapy and catheter manipulation; no mortality occurred.
Conclusions:
- Cardiac catheterization in CHD patients can lead to various arrhythmias.
- Effective management of these arrhythmias is vital to minimize morbidity and mortality.
Objective:
Diagnostic and interventional cardiac catheterization procedures for congenital heart diseases (CHD) are becoming increasingly more popular, and arrhythmia is a well-known complication. This study was an evaluation of the incidence and causative agents of arrhythmia and the subsequent treatment strategies applied during cardiac catheterization.
Methods:
The catheterization data of all of the patients who underwent diagnostic cardiac catheterization for CHD between January 2012 and 2018 at a single center were examined retrospectively.
Results:
A total of 1316 children underwent diagnostic cardiac catheterization due to CHD. The median age and body weight was 18 months (6 days-21 years) and 9.9 kg (2.2-135 kg), respectively. Patients with ventricular septal defect (281 patients) and those with tetralogy of Fallot (257 patients) represented 2 major groups of the study population. In 93 (7%) patients, arrhythmia developed during cardiac catheterization. Among them, there were 58 (62%) cases of bradyarrhythmia and 35 (38%) cases of tachyarrhythmia. Arrhythmia was classified as low, high, or major, according to the adverse event severity score; the rates were 2.7%, 4.3%, and 1.2%, respectively. In 36 (39%) patients, there was no need for therapy, whereas 57 (61%) required treatment to eliminate the arrhythmia. Treatment modalities included catheter manipulation in 15, pharmacological therapy in 24, and cardioversion in 3 patients. Eleven patients required cardiopulmonary resuscitation. Temporary pacemaker implantation was required in 2 patients, while 2 others underwent permanent pacemaker implantation secondary to catheterization-related arrhythmia. There were no cases of mortality secondary to catheterization-related arrhythmia.
Conclusion:
Diagnostic cardiac catheterization in CHD may result in various types of cardiac arrhythmias. The proper management of arrhythmias may reduce morbidity and mortality related to cardiac catheterization.
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