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- Title
Risk Factors for Development of Ectopic Atrial Tachycardia in Post-operative Congenital Heart Disease.
- Authors
Clark, Bradley C.; Berger, John T.; Berul, Charles I.; Kaltman, Jonathan R.; Sherwin, Elizabeth D.; Moak, Jeffrey P.; Jonas, Richard A.; Sinha, Pranava; Lapsa, Julianne; Nath, Dilip S.; Zurakowski, David
- Abstract
Ectopic atrial tachycardia (EAT) is common in surgically repaired congenital heart disease (CHD) and carries the potential for significant hemodynamic compromise. Our objective was to determine the incidence, and risk factors of EAT after CHD surgery. Prospective study of patients that underwent surgery for CHD from February to October 2016 was performed. Demographic, perioperative and electrophysiologic data were collected. Sustained EAT (> 30 s) was documented by telemetry or electrocardiogram and confirmed by a pediatric electrophysiologist. All patients were followed through index hospitalization. During the study period, 17/204 (8%) of patients developed EAT with median time-to-event of 14 days. 15/17 (88%) received anti-arrhythmic therapy for sustained EAT. By univariate analysis, younger age (5 vs. 284 days, <italic>P</italic> < .001), lower weight (3.2 vs. 7.5 kg, <italic>P</italic> < .001), single ventricle physiology (<italic>P</italic> = .05), longer cardiopulmonary bypass time (176 vs. 94 min, <italic>P</italic> < .001), need for delayed sternal closure (<italic>P</italic> < .001), and higher STAT category (<italic>P</italic> < .001) were associated with EAT. Incidence among single ventricle patients was 7/44 (16%), and of those 7/13 (54%) were < 30 days of age. Multivariable Cox regression analysis confirmed age at surgery < 30 days (hazard ratio = 11.7, <italic>P</italic> = .002) and use of milrinone (hazard ratio = 4.4, <italic>P</italic> = .007) as independent predictors of EAT. Post-operative EAT is frequent following surgery for CHD especially in neonates. Further study is warranted, specifically in the single ventricle population, given the high potential risk for arrhythmia-induced hemodynamic compromise in this vulnerable population.
- Subjects
TACHYCARDIA; CONGENITAL heart disease; ARRHYTHMIA; POSTOPERATIVE period; HEMODYNAMICS; SURGERY; DISEASE risk factors
- Publication
Pediatric Cardiology, 2018, Vol 39, Issue 3, p459
- ISSN
0172-0643
- Publication type
Article
- DOI
10.1007/s00246-017-1773-8