Arrhythmias as early post-operative complications of cardiac surgery in children at Cairo University

Abstract

Arrhythmias are a recognized complication of cardiac operations in pediatrics. The aim of the study was to assess the incidence and type of arrhythmias in early post pediatric cardiac surgery patients and to analyze possible risk factors. This is a retrospective study conducted on patients who were followed in post-operative clinic at Cairo University Children's Hospital during the period from September 2007 till January 2009. The following data were collected for each patient; demographic data, pre-operative arrhythmia present, surgical data and post-operative intensive care course. During the study period, 110 patients were enrolled; including 15/110 who had palliative surgery, while 95 out of 110 had corrective surgery. Thirty patients (27.2%) developed post-operative arrhythmias and most of them on day one (60%). Of them 20/30 (66.6%) were cyanotic, while 10/30 (33.3%) were acyanotic. Two (6.6%) had palliative surgery, while 28/30 (93.3%) had corrective surgery. The most common acute post-operative arrhythmias were junctional ectopic tachycardia and Supraventricular tachycardia (33.3%) for each. Out of 95 patients who had corrective surgery, 28 (29.4%) developed arrhythmias most of them (96.4%) within first 48 h post-operatively. they were early after repair of tetralogy of Fallot (18.1%) and (12.1%), respectively. Risk factors for arrhythmias in corrective surgery; such as young age, lower body weight and cyanosis (p<0.05), longer cardiopulmonary bypass time (p<0.05), redooperation (p<0.01), post-operative acidosis, high inotropic support, hypotension and mechanical ventilation (p<0.01), patient with moderate operative risk, post-operative higher doses of inotropic support, longer ventilation time were statistically significance with p<0.001. Younger age, lower body weight, cyanosis, longer cardiopulmonary bypass time, Re-do procedure, acidosis, mechanical ventilation and high inotropic support are the risk factors for post-operative arrhythmias. Junctional ectopic tachycardia and supraventricular tachycardia were the most common post-operative arrhythmias.