Key result
In pediatric patients undergoing open cardiac surgery, the overall incidence of junctional ectopic tachycardia was 13.8%, and its development was associated with longer cardiopulmonary bypass times and prolonged hospitalization.
Why the study?
What are the risk factors for and outcomes of junctional ectopic tachycardia in pediatric patients post open cardiac surgery?
Cohort
No
What are the risk factors for and outcomes of junctional ectopic tachycardia in pediatric patients post open cardiac surgery?
Longer cardiopulmonary bypass and aortic cross-clamp times increase the risk of junctional ectopic tachycardia in pediatric open heart surgery, which is associated with prolonged ventilation and hospital stays.
Supports heightened vigilance with prolonged bypass; hypothesis-generating for prevention trials in pediatric cardiac surgery.
Background Junctional ectopic tachycardia (JET) is a plausible life-undermining tachycardia. It mostly happens more often than not in the initial 24–48 h after surgical adjustment of inherent heart deformities when systolic and diastolic capacity of the heart is weakened. The aim of the study was to determine the overall incidence of JET in pediatric patients post open cardiac surgery, possible preoperative and intraoperative risk factors linked with JET, and the effect of JET on morbidity and mortality. Methods We conducted a retrospective cohort study of all pediatric patients, age ranged from 0 to 14 years, who underwent open cardiac surgery between 2011 and 2015 in our institution at King Abdul-Aziz University Hospital at Jeddah city, KSA. JET patients were compared with other patients underwent open cardiac surgery who did not develop JET regarding possible risk factors and outcomes. Results The overall incidence of JET in pediatric post open cardiac surgery was 13.8%. Longer cardiopulmonary bypass (CPB) time (90.22 ± 37.8 min, 95% CI 0.92–35.6) was independently associated with JET. Multivariate analyses showed that longer aortic cross clamp (ACC) time (64.6 ± 25.9 min, 95%CI 0.32–29.2) increased risk of developing JET. Patients who developed JET had longer time of ventilation, intensive care unit stays, and hospitalization course (p = 0.006, p = 0.028, p = 0.027, respectively). Conclusions Longer surgical procedure demonstrated in this study by longer CPB time and longer ACC time contributed to the overall risk of developing JET. Developing JET was associated with worse outcomes.
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Al-Sofyani et al. (2017) conducted a cohort in Pediatric patients post open cardiac surgery. Open cardiac surgery was evaluated on Overall incidence of junctional ectopic tachycardia (JET). In pediatric patients undergoing open cardiac surgery, the overall incidence of junctional ectopic tachycardia was 13.8%, and its development was associated with longer cardiopulmonary bypass times and prolonged hospitalization.
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