ISSN 1016-5169 | E-ISSN 1308-4488
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Junctional Ectopic Tachycardia After Congenital Heart Surgery: Incidence, Risk Factors, And Outcomes [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-77449 | DOI: 10.5543/tkda.2024.77449

Junctional Ectopic Tachycardia After Congenital Heart Surgery: Incidence, Risk Factors, And Outcomes

Emine Hekim Yılmaz1, Nurgül Yurtseven2, Oktay Korun3, Murat Çiçek4, Hüseyin Karadağ1, Murat Sürücü1, İbrahim Halil Demir1, Numan Ali Aydemir1, Ahmet Çelebi1
1Department of Pediatric Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye
2Department of Anesthesia and Reanimation, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye
3Department of Pediatric Cardiovascular Surgery, Istanbul University-Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
4Department of Pediatric Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye


OBJECTIVE
Postoperative junctional ectopic tachycardia (JET) is usually a self-limiting condition, however in combination with atrioventricular dissociation and postoperative ventricular dysfunction, it may increase morbidity and mortality. The present study aimed to find the overall incidence of JET following congenital heart surgery, to determine patient and procedure-related risk factors for JET, and to evaluate the clinical impact of JET on outcomes.


METHOD
The records of 2814 patients, who underwent cardiac surgery during 5 year period, were reviewed retrospectively to identify patients with JET. For each patient with JET, two controls who underwent surgery during the same period were chosen to compare with JET patients regarding possible risk factors and outcomes.


RESULTS
The incidence of JET following congenital heart surgery was 2.66 % in this large group of patients. Univariate analyses showed statistically significant associations between young age, small body weight, high vasoactive inotrope score, operations involving ventricular septum, surgical complexity score, increased cardiopulmonary bypass time, delayed sternal closure, ECMO requirement, and increased risk of postoperative JET. Following multivariate analysis, only the association between surgeries that involve ventricular septum, ECMO requirement, and increased risk of JET persisted. Compared with controls, JET patients had prolonged lengths of intubation, longer intensive care unit and hospital stays, frequent unplanned re-interventions, and higher mortality.


CONCLUSION
JET can cause serious hemodynamic consequences in patients following congenital heart surgery, and is associated with worse clinical outcomes. Both patient and procedure related factors contribute to the overall risk of developing JET. Describing associations and predictors of JET can help to improve outcomes.

Keywords: Congenital heart disease, congenital heart surgery, junctional ectopic tachycardia, postoperative arrhythmia

How to cite this article


Corresponding Author: Emine Hekim Yılmaz
Manuscript Language: English


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Journal Citation Indicator: 0.18
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SCImago Journal Rank: 0.348

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