Postoperative junctional ectopic tachycardia

Bouzas‐Mosquera, Alberto; Rueda-Núñez, Fernando; Mosquera-Pérez, Ignacio

doi:10.1016/j.acvd.2008.10.016

Cited by 4 publications

(3 citation statements)

References 1 publication

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“…The rhythm does not respond to electrical cardioversion. 2 The dysrhythmia has been commonly observed following cardiac surgery, and its presence may be a marker of an untoward effect of the surgical procedure. 3 Risk factors for the development of JET include young age ( Ͻ 30 days), weight less than 4 kg, aortic cross-clamp time more than 60 minutes, cardiopulmonary bypass time more than 100 minutes, and postoperative magnesium and potassium levels that are lower than normal levels.…”

Section: Discussionmentioning

confidence: 99%

Ventricular Fibrillation Following Synchronized Cardioversion in Junctional Ectopic Tachycardia

Kelly

Shoun

Mikol

et al. 2014

AACN Advanced Critical Care

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J unctional ectopic tachycardia (JET) has been observed in up to 11.4% of pediatric patients after cardiac surgery and is the most common tachyarrhythmia during the early postoperative period. 1 Following surgery, the heart is vulnerable to the negative effects of a high heart rate and atrioventriular (AV) asynchrony, which can lead to hemodynamic instability, decreasing cardiac output. Accurate identification of JET is critical because it is not amenable to synchronized cardioversion and is an important factor in postoperative morbidity. 1 The following case is an example of the cardioversion attempt of a perfusing tachyarrhythmia mistakenly identified as supraventricular tachycardia (SVT). Case ReportA 5-month-old, 8.7-kg, female infant underwent surgical treatment of complete atrial-ventricular septal defect with a common atrium, left-looped ventricles, pulmonary atresia with confluent pulmonary arteries, and dextrocardia. A Glenn shunt and AV valvuloplasty was performed with a cardiopulmonary bypass time of 225 minutes and aortic cross-clamp time of 47 minutes.Adenosine was successfully used in the operating room for SVT after cardiopulmonary bypass was discontinued. Intermittent tachycardia continued throughout the first postoperative night. The morning of postoperative day 1, the patient was tachycardiac ( Ͼ 200/min) with a variable arterial blood pressure. Supraventricular tachycardia was suspected, and the child was cardioverted using 0.5 J/kg of body weight ( Figure 1 ). Immediately afterward ventricular fibrillation occurred without measurable blood pressure or detectable pulse. Defibrillation using 2 J/kg of body weight was immediately performed with restoration of tachyarrhythmia (220/min) with variable blood pressure present ( Figure 2 ). Cardiologists were contacted and

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Section: Discussionmentioning

confidence: 99%

Ventricular Fibrillation Following Synchronized Cardioversion in Junctional Ectopic Tachycardia

Kelly

Shoun

Mikol

et al. 2014

AACN Advanced Critical Care

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“…Focal junctional tachycardia is a narrow QRS complex tachycardia caused by abnormally rapid discharges from the atrioventricular junction area. Although it is believed that a re‐entrant mechanism utilizing several separate longitudinally oriented strands is the most likely electrophysiologic basis for the tachycardia, it is not possible to exclude an automatic focus in a component of the atrioventricular junction area . In human beings, FJT is a rare arrhythmia mostly observed in pediatric patients, presenting as a congenital or postsurgical form.…”

Section: Discussionmentioning

confidence: 99%

“…In human beings, FJT is a rare arrhythmia mostly observed in pediatric patients, presenting as a congenital or postsurgical form. Its incessant nature is responsible for a poor prognosis even when FJT is occasionally observed in adulthood . The electrocardiographic features of FJT in human beings include a heart rate ranging from 110 to 250 bpm, narrow QRS complexes, and the presence of atrioventricular dissociation although 1 : 1 retrograde conduction may be observed .…”

Section: Discussionmentioning

confidence: 99%

Isorhythmic Atrioventricular Dissociation in Labrador Retrievers

Perego¹,

Ramera²,

Santilli³

2012

Veterinary Internal Medicne

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The Medical Management of Pediatric Arrhythmias

Escudero

Carr

Sanatani

2012

Curr Treat Options Cardio Med

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Arrhythmias are an important cause of morbidity and mortality in children. Despite recent technological advances in treatment, pharmacologic therapy remains the most common treatment modality for pediatric arrhythmias. The choice of antiarrhythmic agent, the duration of therapy, and the dosing schedule depend on multiple factors including the recurrence risk and the arrhythmia burden (the latter being determined by the hemodynamic effect of the arrhythmia), and the frequency and duration of episodes. As with all pediatric medications, consideration must be given to the drug formulation, palatability, adverse effects and adherence issues. There are very few randomized trials available to guide the choice of therapy for pediatric arrhythmias, and thus treatment options often reflect physician or institutional preferences. Although various classification schemes exist, we classify antiarrhythmic agents based on their primary site of action: atrial muscle/accessory pathway (class IA, IC, and III agents); the atrioventricular node (beta-blockers, calcium channel blockers, digoxin, and class III agents); or ventricular muscle (class I and III agents). This type of categorization assists in the approach to treatment required for each type of arrhythmia encountered.

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Postoperative junctional ectopic tachycardia

Cited by 4 publications

References 1 publication

Ventricular Fibrillation Following Synchronized Cardioversion in Junctional Ectopic Tachycardia

Ventricular Fibrillation Following Synchronized Cardioversion in Junctional Ectopic Tachycardia

Isorhythmic Atrioventricular Dissociation in Labrador Retrievers

The Medical Management of Pediatric Arrhythmias

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