Turk Kardiyol Dern Ars. Ahead of Print: TKDA-06025
Arrhythmia during diagnostic cardiac catheterization in pediatric patients with congenital heart disease
, Ibrahim Cansaran Tanıdır1
, Erkut Öztürk2
, Selman Gökalp1
, Gülhan Tunca Şahin1
, Mehmet Akın Topkarcı3
, Yakup Ergül1
, Alper Güzeltaş11
Department of Pediatric Cardiology, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey2
Istanbul Gelisim University, Istanbul, Turkey3
Department of Anesthesiology and Reanimation, University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey
OBJECTIVE Diagnostic and interventional cardiac catheterization procedures for congenital heart diseases (CHD) are becoming increasingly more popular and arrhythmia is a well-known complication. In this study we evaluated the incidence and causative agents of arrhythmia and the subsequent treatment strategies applied during cardiac catheterization.Patients: We evaluated the catheterization data of all patients who underwent diagnostic cardiac catheterization for CHD between January 2012 and 2018, retrospectively.
RESULTS A total of 1316 children underwent diagnostic cardiac catheterization due to CHD. Median age and body weight was 18 months (6 days-21 years) and 9.9 kg (2.2135 kg), respectively. Two major groups of patients had ventricular septal defect (281 patients) and tetralogy of Fallot (257 patients). In 93 (7%) patients, arrhythmia developed during cardiac catheterization. Among them, there were 58 (62%) cases of bradyarrhythmia and 35 (38%) of tachyarrhythmia. Arrhythmia was classified as low, high, or major according to the adverse event severity score; the rates were 2.7%, 4.3%, and 1.2%, respectively. In 36 (39%) patients, there was no need for therapy, whereas 57 (61%) required treatment to eliminate arrhythmia. Treatment modalities included catheter manipulation in 15, pharmacological therapy in 24, and cardioversion in three patients. Eleven patients required cardiopulmonary resuscitation. Temporary pacemaker implantation was required in two patients, while two others underwent permanent pacemaker implantation secondary to catheterization-related arrhythmia. There were no cases of mortality secondary to catheterization-related arrhythmia.
CONCLUSIONS Diagnostic cardiac catheterization in CHD may result in different cardiac arrhythmias.The proper management of these arrhythmias may reduce morbidity and mortality related to cardiac catheterization.
cardiac catheterization, children, congenital heart defect, rhythm disturbances
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Corresponding Author: Ibrahim Cansaran Tanıdır, Türkiye