Risk of Recurrence and Long-Term Outcomes of Ectopic Atrial Tachycardia After Surgery for Congenital Heart Disease.

Abstract

Introduction: Ectopic atrial tachycardia (EAT) is a postoperative complication of congenital heart surgery, however its postoperative course and risk of recurrence after hospital discharge is not well described. This study aims to describe the characteristics and outcomes of patients with postoperative EAT and the risk of recurrence during follow-up.

Methods: Retrospective cohort study including patients who underwent surgery for congenital heart disease (2010-2022) with EAT within 45 days of surgery.

Results: EAT was diagnosed in 167 patients (age 1.7 [IQR 0.12, 7.9] months), at median 7 [IQR 3, 12] days after surgery. One-third (32%) of patients had a recurrence during initial inpatient hospitalization requiring escalation of dosing or initiation of new medications. Half (56%) of patients were discharged on antiarrhythmics, and treated for median 6 [IQR 3.5, 10] months after surgery. EAT recurred in 21 (13%) patients at median 5 [IQR 1.3, 12] months after surgery. Four patients (2%) required EP study and ablation. Risk factors for recurrence > 3 months after surgery included prior arrhythmia, preoperative ECMO, surgery for truncus arteriosus, bidirectional Glenn, or coronary intervention, sustained EAT, use of intravenous antiarrhythmic, and recurrence in the first 3 months after surgery.

Conclusions: EAT is a postoperative complication mostly affecting infants. Half of patients were discharged on antiarrhythmics. Although often self-resolving, some patients presented with late recurrence and required intervention.