Early Postoperative Arrhythmias after Paediatric Cardiac Surgery

Abstract

Pediatric arrhythmias represent around 55.1 per 100,000 patients assessed in pediatric crisis divisions. Patients with intrinsic coronary illness are at deep rooted hazard for the advancement of arrhythmias. The point of this investigation is to assess the rate and kinds of early postoperative arrhythmias after pediatric cardiovascular medical procedure. Strategies: The current investigation included 227 pediatric patients with intrinsic heart maladies made arrangements for careful repair.All patients will be exposed to Demographic information, Complete cardiovascular conclusion, Preoperative treatment,Operative system, Post-usable boundaries (electrolyte levels, oxygen immersion, blood pH, serum calcium, sodium, and potassium levels), and Electrocardiogram (ECG) , Echocardiography (ECHO). Results: there was slight female power in which female patients represented 52.9% of the complete accomplice, yet rate of arrhythmia was higher in male patients. the examination between the arrhythmic and non-arrhythmic gathering of patients uncovered a measurably critical distinction as respect of sexual orientation, with higher danger of arrythmia in male patients. There was a marginal relationship between more youthful age at activity and arrythmia too (p =0.055). In like manner, the examination between the arrhythmic and non-arrhythmic gathering of patients uncovered a measurably critical distinction as respect of BSA, with lower BSA in arrythmia gathering. End: Lower age, male sexual orientation, lower body weight, longer ACC time, longer mechanical ventilation, longer ICU remain, electrolyte irregularities, and biventricular physiology all are hazard factors for postoperative arrhythmias.Thus, specialists must consider these components preoperatively to have the option to recognize in danger populace and plan the postoperative consideration as needs be.

Prevalence and risk factors analysis of early postoperative arrhythmia after congenital heart surgery in pediatric patients

“…The highest prevalence of CHB was found in the surgical VSD closure procedure, where out of five patients who experienced CHB, three (60%) patients had a surgical VSD procedure. This is consistent with previous studies, CHB is the most common complication after congenital heart defect surgery, 2–4,7,9 and it occurred 1%–6% after congenital heart defects surgery 16 . Atrioventricular node is found in a specific area called the triangle of Koch within the bottom part of the right atrium.…”

“…3,10,20 Regarding the duration of Aortic Cross Clamp (AoX Time), this study found that the mean duration of AoX time was longer in the arrhythmia group, with 115.58 ± 34.38 min compared to the nonarrhythmia group with a mean of 73.59 ± 37.28 min, and it showed a significant difference with a p-value of .001. This result is in line with previous studies by Shalby et al, 7 Delaney et al, 9 and Alotaibi et al, 3 but it is not in line with the previous study by Sidra et al 2 Based on the duration of ischemia (ischemic Time), this study found that the mean duration of ischemic time in the arrhythmia group was longer, with 106.33 ± 30.63 min compared to the nonarrhythmia group with a mean of 65.43 ± 34.50 min, and it showed a significant difference with a p-value of .000. This result is in line with the previous study by Abdel Gawad et al 4 Based on the postoperative electrolyte levels, there were no statistically significant difference found between the arrhythmia and nonarrhythmia groups for sodium levels, while the potassium levels showed the opposite with a p-value of less than .05.…”

“…9 The difference results can also be caused by the measurement method, according to Grosse Wortman, measuring data with Holter monitoring, cause the diagnosis of arrhythmia to be more sensitive than studies using bedside monitoring, so it showed the highest prevalence compared to previous studies. 15 Complete heart block (CHB) is the most common type of arrhythmia after cardiac surgery in this study, with prevalence rate of five patients This is consistent with previous studies, CHB is the most common complication after congenital heart defect surgery, [2][3][4]7,9 and it occurred 1%-6% after congenital heart defects surgery. 16 Atrioventricular node is found in a specific area called the triangle of Koch within the bottom part of the right atrium.…”

“…2,3,9 Despite the difference results from previous research, based on statistical tests, there was no significant difference between gender and the rate of early postoperative arrhythmia in congenital heart surgery, which is consistent with the findings of this study. 2,3,7,9,18 The pathophysiology of early postoperative arrhythmias caused by various conditions such as direct injury at the time of myocardial incision, injury during cannulation, sutures in the cardiac conduction system, and excessive pressure and volume changes that occur acutely after surgery, 19 and our study showed similar result, early postoperative arrhythmia in this study is related to intra-operative factors. There were significant statistical differences between the arrhythmia and nonarrhythmia groups for the duration of cardio pulmonary bypass (CPB time), duration of aortic cross-clamping (AoX time), duration of ischemia (ischemic time), and potassium levels with p-values of .000, .001, .000, and .007, respectively.…”

“…Patient‐related risk factors include age, 4,5 abnormalities of the heart anatomy 2,4,5 and comorbidities. Surgery‐related risk factors include trauma, postsurgical inflammation, 2,5 hemodynamic stress, 5,6 postsurgical myocardial ischemia, 4,5,7 perioperative drugs, and electrolyte disturbances 2,4,5,7 …”