Our Summary

This research study looks at the rates of irregular heart rhythms, or arrhythmias, in children after they have heart surgery, and what might cause these arrhythmias to occur. The study was done at King Abdulaziz University Hospital in Saudi Arabia and included 821 children who had heart surgery between 2015-2020.

They found that about 17% of these children developed an arrhythmia after their surgery. The most common types of arrhythmias were junctional ectopic tachycardia (which is a fast heart rate that originates from an abnormal place in the heart), atrioventricular block (which is a delay or complete block in the signals from the upper chambers of the heart to the lower chambers), and supraventricular tachycardia (which is a fast heart rate that originates from the upper chambers of the heart).

Most of these arrhythmias happened on the first day after surgery. Children who developed arrhythmias were more likely to have longer times on a heart-lung machine during surgery, longer times of having their aorta clamped during surgery, disturbances in their electrolytes (minerals in the body that help the heart function), and unstable blood pressure and heart rate.

So, the study concluded that arrhythmias are common after heart surgery in children, and that these factors may increase the risk of developing an arrhythmia after surgery.

FAQs

  1. What is the incidence of arrhythmia in pediatric patients after cardiac surgery at King Abdulaziz University Hospital?
  2. What are the most common types of arrhythmias that occur postoperatively in pediatric patients who underwent cardiac surgery?
  3. What factors were identified as risks for the development of postoperative arrhythmia in pediatric cardiac surgery patients?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric cardiac surgery is to closely monitor electrolyte levels, maintain hemodynamic stability, and minimize the duration of cardiopulmonary bypass and aortic cross-clamp time to reduce the risk of postoperative arrhythmias. It is important to follow postoperative care instructions carefully and attend all follow-up appointments to ensure a successful recovery.

Suitable For

Patients who are typically recommended for pediatric cardiac surgery include those with congenital heart defects, acquired heart diseases, and other cardiac abnormalities that require surgical intervention. These patients may have conditions such as atrial septal defects, ventricular septal defects, Tetralogy of Fallot, transposition of the great arteries, and other complex cardiac conditions. Patients with severe symptoms, poor cardiac function, and failure to respond to medical management may also be recommended for surgical treatment.

Timeline

Before pediatric cardiac surgery:

  • Patient is diagnosed with a congenital heart defect
  • Patient undergoes preoperative evaluations and tests
  • Surgical plan is discussed with the patient and their family
  • Patient is admitted to the hospital on the day of surgery
  • Patient undergoes anesthesia and is prepared for surgery

After pediatric cardiac surgery:

  • Patient is monitored closely in the intensive care unit postoperatively
  • Patient may experience arrhythmias, electrolyte disturbances, and hemodynamic instability
  • Patient may require additional interventions or medications to manage complications
  • Patient is gradually weaned off of mechanical ventilation and other supportive measures
  • Patient is transferred to a regular hospital room once stable
  • Patient undergoes follow-up evaluations and tests to monitor their recovery and long-term outcomes.

What to Ask Your Doctor

  1. What is the likelihood of my child developing arrhythmia following pediatric cardiac surgery?
  2. What are the most common types of arrhythmias seen in pediatric patients postoperatively?
  3. What are the risk factors for developing postoperative arrhythmias in pediatric patients?
  4. How soon after surgery do postoperative arrhythmias typically occur?
  5. How are postoperative arrhythmias typically managed in pediatric patients?
  6. Are there any specific precautions or interventions that can be taken to reduce the risk of postoperative arrhythmias in pediatric patients?
  7. Are there any long-term effects or complications associated with postoperative arrhythmias in pediatric patients?
  8. How frequently should my child be monitored for arrhythmias following cardiac surgery?
  9. Are there any lifestyle changes or medications that may be necessary for my child following the development of postoperative arrhythmias?
  10. What is the prognosis for pediatric patients who develop postoperative arrhythmias following cardiac surgery?

Reference

Authors: Alotaibi RK, Saleem AS, Alsharef FF, Alnemer ZA, Saber YM, Abdelmohsen GA, Bahaidarah SA. Journal: Saudi Med J. 2022 Oct;43(10):1111-1119. doi: 10.15537/smj.2022.43.10.20220275. PMID: 36261205