The prevalence and outcome of junctional ectopic tachycardia in pediatric cardiac surgery

Abstract

Background

Junctional ectopic tachycardia (JET) is a plausible life-undermining tachycardia. It mostly happens more often than not in the initial 24–48 h after surgical adjustment of inherent heart deformities when systolic and diastolic capacity of the heart is weakened. The aim of the study was to determine the overall incidence of JET in pediatric patients post open cardiac surgery, possible preoperative and intraoperative risk factors linked with JET, and the effect of JET on morbidity and mortality.

Methods

We conducted a retrospective cohort study of all pediatric patients, age ranged from 0 to 14 years, who underwent open cardiac surgery between 2011 and 2015 in our institution at King Abdul-Aziz University Hospital at Jeddah city, KSA. JET patients were compared with other patients underwent open cardiac surgery who did not develop JET regarding possible risk factors and outcomes.

Results

The overall incidence of JET in pediatric post open cardiac surgery was 13.8%. Longer cardiopulmonary bypass (CPB) time (90.22 ± 37.8 min, 95% CI 0.92–35.6) was independently associated with JET. Multivariate analyses showed that longer aortic cross clamp (ACC) time (64.6 ± 25.9 min, 95%CI 0.32–29.2) increased risk of developing JET. Patients who developed JET had longer time of ventilation, intensive care unit stays, and hospitalization course (p = 0.006, p = 0.028, p = 0.027, respectively).

Conclusions

Longer surgical procedure demonstrated in this study by longer CPB time and longer ACC time contributed to the overall risk of developing JET. Developing JET was associated with worse outcomes.