Key result
Postoperative temporary third-degree AV block is linked to junctional ectopic tachycardia, occurring in ~56% of cases.
Why the study?
Junctional ectopic tachycardia is a postoperative complication after congenital heart disease surgery with a mortality rate of up to 14%, prompting evaluation of its risk factors and its association with postoperative temporary third degree AV block.
Is postoperative temporary third degree atrioventricular block associated with the occurrence of junctional ectopic tachycardia in pediatric patients undergoing surgery for congenital heart disease?
Cohort (n=1,158)
No
Is postoperative temporary third degree atrioventricular block associated with the occurrence of junctional ectopic tachycardia in pediatric patients undergoing surgery for congenital heart disease?
Postoperative temporary third degree AV block, younger age, VSD closure, and longer aortic cross-clamping time are strongly associated with postoperative junctional ectopic tachycardia after congenital heart surgery, whereas permanent AV block was never accompanied by JET.
Answers are grounded in this paper and cite their sources.
May prompt enhanced JET monitoring after temporary AV block in pediatric congenital surgery; leaves open prospective validation of risk-stratified protocols.
AIM: Junctional ectopic tachycardia (JET) is a postoperative complication with a mortality rate of up to 14% after surgery for congenital heart disease. This study evaluated the risk factors of JET and explored the association of postoperative temporary third degree atrioventricular (AV) block and the occurrence of JET. MATERIALS AND METHODS: Data were collected retrospectively from 1158 patients who underwent surgery for congenital heart disease. RESULTS: The overall incidence of JET was 2.8%. Temporary third degree AV block occurred in 1.6% of cases. Permanent third degree AV block requiring pacemaker implantation occurred in 1% of cases. In all, 56% of patients with JET had temporary AV block (P < 0.001), whereas no case of postoperative JET was reported in patients with permanent AV block (P = 0.56). temporary third degree AV block did not suffer from JET. CONCLUSIONS: A correlation between temporary third degree AV block and postoperative JET could be observed. The risk factors identified for JET include younger age groups at the time of surgery, longer aortic cross clamping time and surgical procedures in proximity to the AV node.
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Paech et al. (2015) conducted a cohort in Congenital heart disease undergoing open heart surgery with cardiopulmonary bypass (n=1,158). Postoperative temporary third degree atrioventricular (AV) block vs. Absence of postoperative temporary third degree AV block was evaluated on Postoperative junctional ectopic tachycardia (JET) (p=< 0.001). Postoperative temporary third degree AV block was associated with the occurrence of junctional ectopic tachycardia.
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