title: Efficacy of dexmedetomidine for the control of junctional ectopic tachycardia after repair of tetralogy of Fallot.
abstract: BACKGROUND
  Junctional ectopic tachycardia occurs frequently after congenital cardiac surgery and can be a cause of increased morbidity and mortality. Dexmedetomidine (DEX) is an α2 adrenoreceptor agonist, has properties of controlling tachyarrhythmia by regulating the sympatho-adrenal system.
  
  
  OBJECTIVE
  To evaluate the efficacy of DEX for control of junctional ectopic tachycardia after repair of Tetralogy of Fallot (TOF).
  
  
  METHODS
  Two hundred and twenty pediatric cardiac patients with TOFs were enrolled in a prospective randomized control study. Patients underwent correction surgery. They were divided into two groups, i.e., Group 1 (DEX) and Group 2 (control). Heart rate, rhythm, mean arterial pressure (MAP) were recorded after the anesthetic induction (T1), after termination of bypass (T2), after 04 hours (T3), and 08 hours after transferring the patient to intensive care unit (ICU; T4).
  
  
  RESULTS
  Heart rate was comparable between two groups before starting the drug but statistically significant after bypass until 08 hours after transferring the patient to ICU. Junctional ectopic tachycardia occurred more in Group-2 (20%) as compared to Group-1 (9.09%; P = 0.022). Junctional ectopic tachycardia occurs early in Group-2 (0.14 ± 0.527 hours) as compared to Group 1 (0.31 ± 1.29 hours; P = 0.042). The duration of junctional ectopic tachycardia was more prolonged in Group-2 (1.63 ± 3.64 hours) as compared to Group-1 (0.382 ± 1.60 hours; P = 0.012). The time to withdraw from mechanical ventilation and ICU stay of Group 1 patient was less than of Group 2 patients (P = <0.001).
  
  
  CONCLUSIONS
  DEX had a therapeutic role in the prevention of junctional ectopic tachycardia in patients undergoing repair for TOF.
authors.affiliation: Department of Cardiac Anesthesia, All India Institute Medical Sciences, New Delhi, India.
authors.forename: Randhir S
authors.initials: RS
authors.lastname: Rajput
authors.affiliation: Department of Cardiac Anesthesia, All India Institute Medical Sciences, New Delhi, India.
authors.forename: Sambhunath
authors.initials: S
authors.lastname: Das
authors.affiliation: Department of Cardiac Anesthesia, All India Institute Medical Sciences, New Delhi, India.
authors.forename: Neeti
authors.initials: N
authors.lastname: Makhija
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, All India Institute Medical Sciences, New Delhi, India.
authors.forename: Balram
authors.initials: B
authors.lastname: Airan
keywords: Congenital heart disease; dexmedetomidine; junctional ectopic tachycardia; tachyarrhythmias; tetralogy of Fallot