Risk factors of early postoperative cardiac arrhythmia after pediatric cardiac surgery

Alotaibi, Rahaf K; Saleem, Abdulmuti S; Alsharef, Fai F; Alnemer, Zainab A; Saber, Yazan M; Abdelmohsen, Gaser; Bahaidarah, Saud A.

doi:10.15537/smj.2022.43.10.20220275

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…Junctional ectopic tachycardia (JET) dominated, occurring in 51.4% of cases, followed by atrioventricular block (27.1%) and supraventricular tachycardia (10%). Notably, 79.3% of arrhythmias arose within the first 24 hours after surgery [ 3 ].…”

Section: Editorialmentioning

confidence: 99%

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Statistics in the Operating Room: A Cardiovascular Surgeon’s Guide to Numbers That Matter

Bhende,

Sharma,

Krishnakumar

et al. 2024

Cureus

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Pediatric cardiac surgery demands meticulous technique, but optimal outcomes hinge on translating data into actionable insights. This editorial bridges the gap between scalpel and statistical jargon, empowering surgeons to decipher common tests. Descriptive statistics paint portraits of patient cohorts, while hypothesis testing discerns real differences from chance. Regression analysis unveils hidden relationships, predicting outcomes based on complex interplays of variables. Survival analysis tracks the delicate dance of time and survival, informing therapeutic strategies. By embracing statistical fluency, surgeons become architects of personalized care, tailoring interventions to mitigate risks and maximize the precious gift of a beating heart.

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Section: Editorialmentioning

confidence: 99%

“…and supraventricular tachycardia (10%). Notably, 79.3% of arrhythmias arose within the first 24 hours after surgery [3].…”

Section: Srmentioning

confidence: 99%

Statistics in the Operating Room: A Cardiovascular Surgeon’s Guide to Numbers That Matter

Bhende,

Sharma,

Krishnakumar

et al. 2024

Cureus

View full text Add to dashboard Cite

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

Yasa,

Katritama,

Harta

et al. 2024

Journal of Arrhythmia

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BackgroundArrhythmia is one of the most common complications after cardiac surgery. The objectives of this study were to determine the prevalence and analyze the risk factors of postoperative arrhythmia in pediatric patients after cardiac surgery for congenital heart defects (CHD) at a single center in Bali, Indonesia over 2 years period.MethodsA cross‐sectional study, among 120 pediatric patients with CHD who underwent cardiac surgery, 92 patients met inclusion criteria in this study. The data were taken from medical records included demographic data, anthropometry, electrocardiography, surgical procedures, perioperative parameters, electrolyte levels, and management of postoperative arrhythmias.ResultsAmong 92 patients, 14 (15.2%) developed postoperative arrhythmias. Complete heart block (CHB) the most common arrhythmia, observed in five patients (35.7%), followed by supraventricular tachycardia three patients (21.4%). There were statistically significant differences between arrhythmia and nonarrhythmia groups for cardiopulmonary bypass (CPB) duration (171.23 vs. 108.01 min), aortic cross‐clamp duration (115.58 vs. 73.59 min), ischemia duration (106.33 vs. 65.43 min), and potassium level (3.33 vs. 3.88 mmol/L) with p < .05. Based on multivariate linear regression analysis, CPB time and potassium level were found to be independent risk factor.ConclusionsEarly postoperative arrhythmia observed 15.2% in this study, dominated by CHB. CPB duration, aortic cross‐clamping, ischemia time, and potassium level were statistically significantly different between arrhythmia and nonarrhythmia groups.

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Standardized Temporary Atrial Epicardial Wire Locations Lead to Enhanced Atrial Signal Identification

Atlas,

Zhang,

Torgeson

et al. 2024

J Intensive Care Med

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Background: Arrhythmias, common after pediatric cardiac surgery, are associated with increased morbidity and mortality. Atrial epicardial wires (AEW) improve diagnostic accuracy but have variable pacing and sensing properties based on their location. Even so, there are no longitudinal prospective pediatric studies examining ideal placement of AEW. Methods: This multicenter study compared atrial amplitudes, pacing sensitivities and thresholds via AEW placed at Bachmann's Bundle (BB) and the interatrial groove near the right pulmonary veins (IGRPV) versus the surgeons’ standard locations. An AtriAmp system was used to obtain an atrial ECG to calculate atrial and ventricular amplitude from atrial electrograms on the bedside monitor. Sensitivities and thresholds via a temporary pacemaker were documented. ANOVA tests with repeated measures and post-hoc pairwise comparisons were performed to compare variables within the first 24-h postoperative hours. Mixed effects linear regression models were employed to examine daily trends. Results: In the first 24-h following cardiac surgery, AEW at BB and IGRPV showed significantly larger atrial amplitudes than the surgeons’ standard locations. In addition, there was a negative trend in atrial ECG amplitude in all AEW from postoperative days 0 to 1; however, subsequent days showed a positive mean change in atrial amplitude with largest increase seen at BB. Atrial sensing as measured by the temporary pacemaker had statistically greater atrial signal amplitude from the BB-IGRPV set in both polarities (ie, with the BB as the – or + electrode pair) as compared to the surgeons’ standard locations. No difference in atrial thresholds (mA) were noted in the immediate postoperative period or over time, with a relatively low atrial threshold at all sites. Conclusion: Standardization of AEW at Bachmann's Bundle can yield largest atrial amplitudes by atrial ECG and highest atrial sensing parameters without compromising atrial thresholds.

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Risk factors of early postoperative cardiac arrhythmia after pediatric cardiac surgery

Cited by 4 publications

References 22 publications

Statistics in the Operating Room: A Cardiovascular Surgeon’s Guide to Numbers That Matter

Statistics in the Operating Room: A Cardiovascular Surgeon’s Guide to Numbers That Matter

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

Standardized Temporary Atrial Epicardial Wire Locations Lead to Enhanced Atrial Signal Identification

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