title: Electrocardiographic effects of dexmedetomidine in patients with congenital heart disease.
abstract: OBJECTIVE
  Assessment of electrocardiographic (ECG) effects of dexmedetomidine.
  
  
  METHODS
  Prospective observational study including children 0-17 years of age with congenital heart disease (CHD) and children following cardiothoracic surgery. Patients who did not receive dexmedetomidine were used as a control group. All patients had two ECGs: one baseline, pre-dexmedetomidine (T1) and one during dexmedetomidine infusion (T2).
  
  
  RESULTS
  Fifty-one patients, median age of 0.5 years (IQR = 3.4), and 25 patients, age 0.25 (IQR = 2.9), were included in the dexmedetomidine and control groups, respectively. Forty received a dexmedetomidine-loading dose of 1 microg/kg (IQR = 0.5). At T2, the dexmedetomidine infusion was 1 microg/kg/h (IQR = 0.5). In the dexmedetomidine group, heart rate (HR) decreased from 140 +/- 22 to 115 +/- 23 (P < 0.001); PR, PRc and PR index changed from 115 +/- 28 to 122 +/- 29 ms (P = 0.01), 174 +/- 38 to 167 +/- 35 ms (P = 0.07) and 15,882 +/- 3,565 to 13,792 +/- 3,311 (P < 0.001), respectively. QRS decreased from 84 +/- 21 to 80 +/- 21 ms (P = 0.02), and QTc had no change (433 +/- 47 to 435 +/- 36 ms). When compared to the control group, none of the ECG intervals had any difference other than a trend towards lower HR (P = 0.08). Neonates and infants had a bigger drop in the HR compared to older children (P < 0.001), while other parameters were similar. At T2 none of the dexmedetomidine group patients had atrioventricular block or other arrhythmia. Four patients in the control group had accelerated junctional rhythm.
  
  
  CONCLUSIONS
  Use of dexmedetomidine in patients with CHD and patients following cardiothoracic surgery is not associated with any significant ECG interval abnormalities other than a trend towards lower HR.
authors.affiliation: Department of Pediatric Cardiology, Division of Cardiac Intensive Care, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA 15201, USA. chrycx@chp.edu
authors.forename: Constantinos
authors.initials: C
authors.lastname: Chrysostomou
authors.forename: Rukmini
authors.initials: R
authors.lastname: Komarlu
authors.forename: Steven
authors.initials: S
authors.lastname: Lichtenstein
authors.forename: Dana
authors.initials: D
authors.lastname: Shiderly
authors.forename: Gaurav
authors.initials: G
authors.lastname: Arora
authors.forename: Richard
authors.initials: R
authors.lastname: Orr
authors.forename: Peter D
authors.initials: PD
authors.lastname: Wearden
authors.forename: Victor O
authors.initials: VO
authors.lastname: Morell
authors.forename: Ricardo
authors.initials: R
authors.lastname: Munoz
authors.forename: Edmund H
authors.initials: EH
authors.lastname: Jooste
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000009:adverse effects; D000704:Analysis of Variance; D054537:Atrioventricular Block; D006348:Cardiac Surgical Procedures; D020927:Dexmedetomidine / Q000008:administration & dosage* / Q000009:adverse effects; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D006330:Heart Defects, Congenital / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D007223:Infant; D008297:Male; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies
chemical_list: D000316:Adrenergic alpha-Agonists; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine