دورية أكاديمية
أعرض في EDS

Junctional ectopic tachycardia following tetralogy of fallot repair in children under 2 years.

التفاصيل البيبلوغرافية
العنوان: Junctional ectopic tachycardia following tetralogy of fallot repair in children under 2 years.
المؤلفون: Ismail MF; Cardiothoracic Surgery Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O Box: 40047, Jeddah, 21499, Saudi Arabia.; Cardio-thoracic Surgery Department, Mansoura University, Mansoura, Egypt., Arafat AA; Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt., Hamouda TE; Cardiothoracic Surgery Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O Box: 40047, Jeddah, 21499, Saudi Arabia.; Cardio-thoracic Surgery Department, Benha University, Benha, Egypt., El Tantawy AE; The Department of Pediatrics, Faculty of Medicine Cairo University, Cairo, Egypt., Edrees A; Cardiothoracic Surgery Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O Box: 40047, Jeddah, 21499, Saudi Arabia., Bogis A; Cardiothoracic Surgery Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O Box: 40047, Jeddah, 21499, Saudi Arabia., Badawy N; Cardiothoracic Surgery Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O Box: 40047, Jeddah, 21499, Saudi Arabia.; The Department of Pediatrics, Faculty of Medicine Cairo University, Cairo, Egypt., Mahmoud AB; Cardiothoracic Surgery Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O Box: 40047, Jeddah, 21499, Saudi Arabia.; Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt., Elmahrouk AF; Cardiothoracic Surgery Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O Box: 40047, Jeddah, 21499, Saudi Arabia. A_marouky@hotmail.com.; Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt. A_marouky@hotmail.com., Jamjoom AA; Cardiothoracic Surgery Department, King Faisal Specialist Hospital and Research Center, MBC J-16, P.O Box: 40047, Jeddah, 21499, Saudi Arabia.
المصدر: Journal of cardiothoracic surgery [J Cardiothorac Surg] 2018 Jun 05; Vol. 13 (1), pp. 60. Date of Electronic Publication: 2018 Jun 05.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101265113 Publication Model: Electronic Cited Medium: Internet ISSN: 1749-8090 (Electronic) Linking ISSN: 17498090 NLM ISO Abbreviation: J Cardiothorac Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central, 2006-
مواضيع طبية MeSH: Tachycardia, Ectopic Junctional/*epidemiology , Tetralogy of Fallot/*surgery, Cardiac Surgical Procedures/adverse effects ; Female ; Humans ; Infant ; Male ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies ; Risk Factors ; Saudi Arabia/epidemiology ; Sex Factors ; Tachycardia, Ectopic Junctional/etiology
مستخلص: Background: Junctional ectopic tachycardia is a serious arrhythmia that frequently occurs after tetralogy of Fallot repair. Arrhythmia prophylaxis is not feasible for all pediatric cardiac surgery patients and identification of high risk patients is required. The objectives of this study were to characterize patients with JET, identify its predictors and subsequent complications and the effect of various treatment strategies on the outcomes in selected TOF patients undergoing total repair before 2 years of age.
Methods: From 2003 to 2017, 609 patients had Tetralogy of Fallot repair, 322 were included in our study. We excluded patients above 2 years and patients with preoperative arrhythmia. 29.8% of the patients (n = 96) had postoperative JET.
Results: JET patients were younger and had higher preoperative heart rate. Independent predictors of JET were younger age, higher preoperative heart rate, cyanotic spells, non-use of B-blockers and low Mg and Ca (p = 0.011, 0.018, 0.024, 0.001, 0.004 and 0.001; respectively). JET didn't affect the duration of mechanical ventilation nor hospital stay (p = 0.12 and 0.2 respectively) but prolonged the ICU stay (p = 0.011). JET resolved in 39.5% (n = 38) of patients responding to conventional measures. Amiodarone was used in 31.25% (n = 30) of patients and its use was associated with longer ICU stay (p = 0.017). Ventricular pacing was required in 4 patients (5.2%). Median duration of JET was 30.5 h and 5 patients had recurrent JET episode. Timing of JET onset didn't affect ICU (p = 0.43) or hospital stay (p = 0.14) however, long duration of JET increased ICU and hospital stay (p = 0.02 and 0.009; respectively).
Conclusion: JET increases ICU stay after TOF repair. Preoperative B-blockers significantly reduced JET. Patients with preoperative risk factors could benefit from preoperative arrhythmia prophylaxis and aggressive management of postoperative electrolyte disturbance is essential.
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فهرسة مساهمة: Keywords: Arrhythmia; Congenital heart disease; Junctional ectopic tachycardia; tetralogy of Fallot
تواريخ الأحداث: Date Created: 20180607 Date Completed: 20180920 Latest Revision: 20181114
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC5989382
DOI: 10.1186/s13019-018-0749-y
PMID: 29871684
قاعدة البيانات: MEDLINE
الوصف
تدمد:1749-8090
DOI:10.1186/s13019-018-0749-y