Junctional ectopic tachycardia after surgery for congenital heart disease in children.
OBJECTIVE
To determine incidence, predictors and outcome [intensive care unit (ICU) mortality and length of stay (LOS)] after postoperative junctional ectopic tachycardia (JET) in an unselected paediatric population.


METHODS
Patients with JET (n=89) were compared with non-JET controls (n=178) in a nested case-control study.


METHODS
Tertiary ICU at Skejby Sygehus, Aarhus University Hospital, Denmark.


METHODS
The patient records of all children (n=874) who underwent corrective cardiac surgery on cardio-pulmonary bypass (CPB) between 1998 and 2005 were reviewed for postoperative JET.


RESULTS
The association between JET and its potential predictors was examined with multivariate conditional regression analyses. The overall incidence of JET was 10.2%. CPB duration>90 min [adjusted odds ratio (OR) 2.6; 95% confidence interval (CI) 1.1-6.5], high inotropic requirements (adjusted OR 2.6; CI 1.2-5.9) and high postoperative levels of creatine kinase (CK)-MB (adjusted OR 3.1; CI 1.3-7.1) were associated with an increased risk of JET. ICU mortality was higher for patients with JET (13.5%; CI 7.2-22.4%) than for controls (1.7%; CI 0.3-4.8%), and LOS in ICU was 3 times higher in JET patients (median 2 vs. 7 days, p<0.001).


CONCLUSIONS
JET occurred in approximately 10% of children following cardiac surgery and was associated with higher mortality and longer ICU stay. Risk factors included high inotropic requirements after surgery and extensive myocardial injury in terms of high CK-MB values and longer CPB duration.
Andreasen
J B
JB
Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Skejby Sygehus, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark. jbnd@studmed.au.dk
Johnsen
S P
SP
Ravn
H B
HB
D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D012044:Regression Analysis; D012307:Risk Factors; D013613:Tachycardia, Ectopic Junctional / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome