Background
Postoperative arrhythmias after pediatric congenital heart disease (CHD) surgery are
a known cause of morbidity and are associated with mortality. A comprehensive evaluation
of early postoperative ventricular arrhythmias (VAs) after CHD surgery has not been
reported.
Objectives
We sought to determine the incidence of in-hospital VAs after CHD surgery and assess
the clinical relevance of this arrhythmia during the postoperative hospital course.
Methods
Patients undergoing CHD surgery at our center from September 2007 through December
2016 were prospectively enrolled. Univariate and multivariate analysis was used to
assess the association between postoperative VAs and in-hospital mortality, adjusting
for postoperative extracorporeal membrane oxygenation and stage 1 single ventricle
palliation operations.
Results
A total of 2503 postoperative courses in 1835 patients were included. In all, 464
(18.5%) had VAs, of whom 135 (29.1%) received treatment. Monomorphic ventricular tachycardia
was the most frequently treated ventricular arrhythmia (TVA; n=91 [62.3%]). TVAs were
associated with increased postoperative extracorporeal membrane oxygenation (13.3%
vs 5.5%; P < .001) and in-hospital mortality (14.9% vs 4.0%; P < .001). In multivariate analysis, TVA was an independent risk factor for in-hospital
mortality (adjusted odds ratio 2.44; 95% confidence interval 1.21–4.92).
Conclusion
Early postoperative VAs after CHD surgery are more common than previously reported.
Postoperative VAs are associated with increased in-hospital mortality, and the subgroup
of TVAs is an independent risk factor for in-hospital mortality.
Keywords
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Article info
Publication history
Published online: December 04, 2018
Footnotes
This work was supported in part by grants T32HL105334, R01HD084461, and UL1TR000445 from the National Institutes of Health, 12CRP10560001 from the American Heart Association, and CSDA 2017075 from the Doris Duke Charitable Foundation.
Dr Van Driest has received an honorarium from Merck as an invited speaker. The other authors have no relationships with industry to disclose.
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