Incidence and effect of early postoperative ventricular arrhythmias after congenital heart surgery

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Implantation of Total Artificial Heart in Congenital Heart Disease
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Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

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Sarah R Fuchs1, Andrew H Smith2, Sara L Van Driest3

  • 1Department of Pediatrics, Thomas P. Graham Jr. Division of Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee.

Heart Rhythm
|December 12, 2018
PubMed

Insights

Postoperative ventricular arrhythmias (VAs) after pediatric congenital heart disease (CHD) surgery are common and linked to higher mortality. Treated VAs are an independent risk factor for in-hospital death in these patients.

Area of Science:

  • Cardiology
  • Pediatric Surgery
  • Critical Care Medicine

Background:

  • Postoperative arrhythmias are a significant cause of morbidity and mortality in pediatric congenital heart disease (CHD) surgery.
  • A comprehensive evaluation of early postoperative ventricular arrhythmias (VAs) following CHD surgery has been lacking.

Purpose of the Study:

  • To determine the incidence of in-hospital VAs after CHD surgery.
  • To assess the clinical relevance and impact of VAs on postoperative outcomes.

Main Methods:

  • Prospective enrollment of patients undergoing CHD surgery from September 2007 to December 2016.
  • Univariate and multivariate analyses were employed to evaluate associations.
  • Adjustments were made for extracorporeal membrane oxygenation and stage 1 single ventricle palliation operations.

Main Results:

  • 18.5% of 2503 postoperative courses experienced VAs; 29.1% required treatment.
  • Monomorphic ventricular tachycardia was the most frequent treated VA (TVA).
  • TVAs were associated with increased need for extracorporeal membrane oxygenation (13.3% vs 5.5%) and higher in-hospital mortality (14.9% vs 4.0%).

Conclusions:

  • Early postoperative VAs after CHD surgery are more frequent than previously recognized.
  • Postoperative VAs are linked to increased in-hospital mortality.
  • Treated VAs independently predict in-hospital mortality in pediatric CHD surgery patients.
Abstract

Keywords:
ArrhythmiaCardiac surgeryCongenital heart diseasePediatricVentricular tachycardia

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