Early postoperative arrhythmias after cardiac operation in children

Early postoperative arrhythmias after pediatric cardiac surgery

“…1 The incidence of various types of arrhythmia after pediatric cardiac surgery can be up to 48%. [2][3][4] In this study, we found a 7.5% incidence of arrhythmia, which is less than that described in the past, 2-4 but many recent studies have found similar results. 8,9 In most studies, younger age was found to be an important risk factor for arrhythmias after pediatric cardiac surgery.…”

“…8,9 JET was most common arrhythmia, as found in other reported series. [2][3][4] All patients who had JET had a ventricular septal defect either in isolation or with another cardiac malformation. The genesis of JET in this setting could be due to the traction on the tricuspid annulus needed to expose the ventricular septal defect.…”

“…[4][5][6]8,9 Pathophysiological causes of early postoperative arrhythmias include direct surgical injuries such as myocardial incision, cannulation, sutures close to the conduction system, and acute changes in intracardiac pressure caused by volume and pressure overload. [1][2][3][4][5][6][7][8][9][10] Furthermore, cardiopulmonary bypass (CPB) with ischemia-reperfusion and related cellular biochemical effects as well as medical interventions such as electrolyte shifts and catecholamine administration may affect the stability of the cellular membrane and result in increased myocardial irritability and automaticity. 11,12 At the All India Institute of Medical Sciences, nearly 50 open heart surgeries are performed every week for congenital heart disorders of all types.…”

A review of the utility of EEG depth of anaesthesia monitors in the paediatric intensive care environment

“…In post-cardiac surgery children receiving active heart pacing, the AEP monitor was unable to provide the MLAEP due to excessive artefact and, in patients able to have their cardiac pacemakers suspended, the BIS value rose by 10 to 15 points. Within the PIC environment a cardiac pacemaker is a common mode of therapy (Valsangiacomo et al 2002). During pacing, artefact contamination, of either the AEP or BIS monitor outputs, may provide spurious values to the unwitting user.…”

Safety of Transesophageal Pacing for 24 Hours in a Canine Model

“…[1][2][3][4] Approximately 15% of these are hemodynamically significant and can result in congestive heart failure or death. 5 Treatment of such arrhythmias may involve pharmacologic intervention, direct current (DC) cardioversion, or temporary atrial pacing. Temporary cardiac pacing is most commonly established by placement of epicardial pacing wires during open surgical repair.…”