title: Junctional ectopic tachycardia following repair of congenital heart defects-experience in multimodal management from a West African Centre.
abstract: BACKGROUND
  Postoperative junctional ectopic tachycardia (JET) is a rare and transient phenomenon occurring after repair of congenital heart defects. Report on this arrhythmia in the subregion is rare. We set out to determine the incidence of this arrhythmia and review the treatment and outcomes of treatment in our centre.
  
  
  METHODS
  Retrospective search of the records of all patients aged 18 years and below admitted into the intensive care unit (ICU) following repair or palliation of a congenital heart defect over 5 years, from January 1, 2006 to December 31, 2010. A review of clinical notes, operative records, anaesthetic charts, cardiopulmonary bypass (CPB) records, nursing observation charts, electrocardiograms (ECGs) and out-patient follow-up records was undertaken.
  
  
  RESULTS
  510 children under 18 years were enlisted. 7 cases of postoperative JET were recorded, (1.37%). 184 (36.1%) of these were performed under CPB. All JET cases were from cases done under CPB, 3.8%. Median age was 3 years and median weight 11.3 kg. No patient was febrile at diagnosis. 4 patients had amiodarone administration, 5 had magnesium sulphate infusion, 2 patients had direct current shock (DCS) whilst 3 patients had all three therapeutic modalities. All patients had control of the arrhythmia with conversion to sinus rhythm and no recurrence.
  
  
  CONCLUSIONS
  We report a JET incidence of 1.37% among children undergoing CPB for repair of congenital heart defects. We demonstrate the therapeutic effectiveness of amiodarone, magnesium sulphate infusions and DCS alone or in combination in the management of JET on various substrates with good outcome.
authors: National Cardiothoracic Centre, Korle-Bu Teaching Hospital, P. O. Box KB 846, Korle-Bu, Accra, Ghana.
authors: Kow
authors: K
authors: Entsua-Mensah
authors: Ernest
authors: E
authors: Aniteye
authors: Lawrence Agyemang
authors: LA
authors: Sereboe
authors: Mark Mawutor
authors: MM
authors: Tettey
authors: Frank
authors: F
authors: Edwin
authors: Martin
authors: M
authors: Tamatey
authors: Ibrahim
authors: I
authors: Delia
authors: Kofi Bafoe
authors: KB
authors: Gyan
mesh_terms: D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005869:Ghana; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D011183:Postoperative Complications / Q000628:therapy*; D012189:Retrospective Studies; D013613:Tachycardia, Ectopic Junctional / Q000628:therapy*