PURPOSE: Early postoperative arrhythmias are a major cause of
mortality and
morbidity after open
heart surgery in the pediatric
population . We evaluated the
incidence and
risk factors of early postoperative arrhythmias after
surgery of
congenital heart disease .
METHODS: From January 2002 to December 2008, we retrospectively reviewed the
medical records of the 561
patients who underwent
cardiac surgery in Kyungpook National
University Hospital . We analyzed
patients ' age and weight, occurrence and type of
arrhythmia ,
cardiopulmonary bypass (CPB)
time , aortic cross clamp (ACC)
time , and postoperative
electrolyte levels.
RESULTS: Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric
cardiac surgery . The most common types of
arrhythmia were
junctional ectopic tachycardia (JET) and
accelerated idioventricular rhythm (
AIVR ), which occurred in 17 and 13 cases, respectively. The
arterial switch operation (ASO) of transposition of the great
arteries (TGA) had the highest
incidence of
arrhythmia (36.4%). Most cases of
cardiac arrhythmia showed good response to management.
Patients with early postoperative arrhythmias had significantly lower
body weight , younger age, and prolonged CPB and ACC times (P<0.05) than
patients without
arrhythmia . Although the mean duration of
ventilator care and
intensive care unit stay were significantly longer (P<0.05), the mortality rate was not significantly different among the 2 groups.
CONCLUSION: Early postoperative arrhythmias are a major complication after pediatric
cardiac surgery ; however, aggressive and immediate management can reduce
mortality and
morbidity .