Arrhythmia in early post cardiac surgery in pediatrics: Siriraj experience.

Chaiyarak, Kanoknaphat; Soongswang, Jarupim; Durongpisitkul, Kritvikrom; Laohaprasitiporn, Duangmanee; Chanthong, Prakul; Nana, Apichart; Sriyodcharti, Somchai; Subtaweesin, Thaworn; Prakanrattana, Ungkab

Arrhythmia in early post cardiac surgery in pediatrics: Siriraj experience.

Date

2008-04-18

Authors

Chaiyarak, Kanoknaphat

Soongswang, Jarupim

Durongpisitkul, Kritvikrom

Laohaprasitiporn, Duangmanee

Chanthong, Prakul

Nana, Apichart

Sriyodcharti, Somchai

Subtaweesin, Thaworn

Prakanrattana, Ungkab

Abstract

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 1st to December 31st, 2006. The collected data were demographic data, diagnosis, pre-operative arrhythmia, cardiac surgical data and continuous electrocardiographic 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 1 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.

Description

Chotmaihet Thangphaet.

Citation

Chaiyarak K, Soongswang J, Durongpisitkul K, Laohaprasitiporn D, Chanthong P, Nana A, Sriyodcharti S, Subtaweesin T, Prakanrattana U. Arrhythmia in early post cardiac surgery in pediatrics: Siriraj experience. Journal of the Medical Association of Thailand. 2008 Apr; 91(4): 507-14