A prospective analysis of the incidence and risk factors associated with junctional ectopic tachycardia following surgery for congenital heart disease

A. S. Batra, D. S. Chun, T. R. Johnson, E. M. Maldonado, B. A. Kashyap, J. Maiers, C. L. Lindblade, M. Rodefeld, J. W. Brown, J. E. Hubbard

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Abstract

This study was designed to evaluate the incidence and risk factors associated with the occurrence of junctional ectopic tachycardia (JET) in patients after congenital heart surgery. We prospectively analyzed cardiac rhythm status in 336 consecutive patients undergoing surgery for congenital heart disease at our institution during a 1-year period. The incidence of JET was 8% (27/336). Repairs with the highest incidence of JET were arterial switch operation (3/13, 23%), atrioventricular (AV) canal repair (4/19, 21%), and Norwood repair (2/10, 20%). Compared to patients with no arrhythmias, patients with JET were more likely to be younger (2.75 ± 2.44 vs 5.38 ± 7.25 years, p < 0.01), have had longer cardiopulmonary bypass times (126 ± 50 vs 85 ± 73, p < 0.01), and have a higher inotrope score (6.26 ± 7.55 vs 2.41 ± 8.11, p < 0.01). By multivariate analysis, ischemic time was the only factor associated with JET [odds ratio, 1.01 (confidence interval, 1.005-1.02); p = 0.0014). The presence of JET did not correlate with electrolyte abnormalities. JET is not necessarily related to surgery near the His bundle or hypomagnesemia. Longer ischemic time is the best predictor of JET. Patients undergoing arterial switch operation, AV canal repair, and Norwood repair are at highest risk of postoperative JET and should be considered for prophylactic therapy.

Original languageEnglish (US)
Pages (from-to)51-55
Number of pages5
JournalPediatric Cardiology
Volume27
Issue number1
DOIs
StatePublished - Feb 1 2006

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Ectopic Junctional Tachycardia
Heart Diseases
Incidence
Bundle of His
Cardiopulmonary Bypass
Electrolytes
Thoracic Surgery
Cardiac Arrhythmias
Multivariate Analysis

Keywords

  • Arrhythmias
  • Congenital heart disease
  • Heart surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

A prospective analysis of the incidence and risk factors associated with junctional ectopic tachycardia following surgery for congenital heart disease. / Batra, A. S.; Chun, D. S.; Johnson, T. R.; Maldonado, E. M.; Kashyap, B. A.; Maiers, J.; Lindblade, C. L.; Rodefeld, M.; Brown, J. W.; Hubbard, J. E.

In: Pediatric Cardiology, Vol. 27, No. 1, 01.02.2006, p. 51-55.

Research output: Contribution to journalArticle

Batra, A. S. ; Chun, D. S. ; Johnson, T. R. ; Maldonado, E. M. ; Kashyap, B. A. ; Maiers, J. ; Lindblade, C. L. ; Rodefeld, M. ; Brown, J. W. ; Hubbard, J. E. / A prospective analysis of the incidence and risk factors associated with junctional ectopic tachycardia following surgery for congenital heart disease. In: Pediatric Cardiology. 2006 ; Vol. 27, No. 1. pp. 51-55.
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AB - This study was designed to evaluate the incidence and risk factors associated with the occurrence of junctional ectopic tachycardia (JET) in patients after congenital heart surgery. We prospectively analyzed cardiac rhythm status in 336 consecutive patients undergoing surgery for congenital heart disease at our institution during a 1-year period. The incidence of JET was 8% (27/336). Repairs with the highest incidence of JET were arterial switch operation (3/13, 23%), atrioventricular (AV) canal repair (4/19, 21%), and Norwood repair (2/10, 20%). Compared to patients with no arrhythmias, patients with JET were more likely to be younger (2.75 ± 2.44 vs 5.38 ± 7.25 years, p < 0.01), have had longer cardiopulmonary bypass times (126 ± 50 vs 85 ± 73, p < 0.01), and have a higher inotrope score (6.26 ± 7.55 vs 2.41 ± 8.11, p < 0.01). By multivariate analysis, ischemic time was the only factor associated with JET [odds ratio, 1.01 (confidence interval, 1.005-1.02); p = 0.0014). The presence of JET did not correlate with electrolyte abnormalities. JET is not necessarily related to surgery near the His bundle or hypomagnesemia. Longer ischemic time is the best predictor of JET. Patients undergoing arterial switch operation, AV canal repair, and Norwood repair are at highest risk of postoperative JET and should be considered for prophylactic therapy.

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