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Predictors of Early Postoperative Supraventricular Tachyarrhythmias in Children After the Fontan Procedure

Jun Yasuhara1,2, Toshiki Kuno3, Moe Taki1

  • 1Department of Pediatric Cardiology, Saitama Medical University International Medical Center.

International Heart Journal
|November 19, 2019
PubMed

Insights

Postoperative arrhythmias after the Fontan operation are common. Moderate to severe atrioventricular valve regurgitation and prior arrhythmias predict early supraventricular tachyarrhythmias (SVTs).

Area of Science:

  • Pediatric Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Postoperative arrhythmias are a frequent and potentially fatal complication following the Fontan operation.
  • Limited clinical evidence exists on early postoperative arrhythmias in pediatric patients undergoing the Fontan procedure.

Purpose of the Study:

  • To evaluate the prevalence of early postoperative arrhythmias after the Fontan procedure.
  • To identify predictors of early postoperative supraventricular tachyarrhythmias (SVTs).

Main Methods:

  • Retrospective analysis of 80 pediatric patients who underwent Fontan procedures.
  • Definition of early postoperative SVTs as arrhythmias within 30 days post-procedure.
  • Multivariate logistic regression analysis to identify independent predictors.

Main Results:

  • Early postoperative SVTs occurred in 26.3% of patients, with junctional ectopic tachycardia being most common.
  • Atrioventricular valve regurgitation (AVVR) grade ≥2 (OR 10.54) and preoperative arrhythmias (OR 26.49) were significant predictors.
  • These predictors were identified after adjusting for other factors.

Conclusions:

  • AVVR grade ≥2 and preoperative arrhythmias are significant predictors of early postoperative SVTs.
  • Interventions targeting AVVR may help prevent early postoperative arrhythmias after Fontan operations.

Keywords:
Arrhythmias following cardiac surgeryAtrioventricular valve regurgitationFontan operationJunctional ectopic tachycardiaPredictive factors

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