Turk Kardiyol Dern Ars. 2018; 46(8): 675-682 | DOI: 10.5543/tkda.2018.06025
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, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey2
Department of Pediatric Cardiology, İstanbul Gelişim University, İstanbul, Turkey3
Department of Anesthesiology and Reanimation, University of Health Sciences, İstanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, 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. This study was an evaluation of the incidence and causative agents of arrhythmia and the subsequent treatment strategies applied during cardiac catheterization.
METHODS The catheterization data of all of the patients who underwent diagnostic cardiac catheterization for CHD between January 2012 and 2018 at a single center were examined retrospectively.
RESULTS A total of 1316 children underwent diagnostic cardiac catheterization due to CHD. The median age and body weight was 18 months (6 days-21 years) and 9.9 kg (2.2135 kg), respectively. Patients with ventricular septal defect (281 patients) and those with tetralogy of Fallot (257 patients) represented 2 major groups in the study population. In 93 (7%) patients, arrhythmia developed during cardiac catheterization. Among them, there were 58 (62%) cases of bradyarrhythmia and 35 (38%) cases 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 the arrhythmia. Treatment modalities included catheter manipulation in 15, pharmacological therapy in 24, and cardioversion in 3 patients. Eleven patients required cardiopulmonary resuscitation. Temporary pacemaker implantation was required in 2 patients, while 2 others underwent permanent pacemaker implantation secondary to catheterization-related arrhythmia. There were no cases of mortality secondary to catheterization-related arrhythmia.
CONCLUSION Diagnostic cardiac catheterization in CHD may result in various types of cardiac arrhythmias. The proper management of arrhythmias may reduce morbidity and mortality related to cardiac catheterization.
Cardiac catheterization, children; congenital heart defect; rhythm disturbances
How to cite this article
Taner Kasar, Ibrahim Cansaran Tanıdır, Erkut Öztürk, Selman Gökalp, Gülhan Tunca Şahin, Mehmet Akın Topkarcı, Yakup Ergül, Alper Güzeltaş. Arrhythmia during diagnostic cardiac catheterization in pediatric patients with congenital heart disease. Turk Kardiyol Dern Ars. 2018; 46(8): 675-682
Corresponding Author: Ibrahim Cansaran Tanıdır, Türkiye