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Junctional ectopic tachycardia after infant heart surgery: incidence and outcomes.

TitleJunctional ectopic tachycardia after infant heart surgery: incidence and outcomes.
Publication TypeJournal Article
Year of Publication2012
AuthorsZampi, JD, Hirsch, JC, Gurney, JG, Donohue, JE, Yu, S, LaPage, MJ, Hanauer, DA, Charpie, JR
JournalPediatr Cardiol
Volume33
Issue8
Pagination1362-9
Date Published2012 Dec
ISSN1432-1971
KeywordsCardiopulmonary Bypass, Case-Control Studies, Chi-Square Distribution, Extracorporeal Membrane Oxygenation, Female, Heart Defects, Congenital, Humans, Incidence, Infant, Infant, Newborn, Intubation, Intratracheal, Length of Stay, Male, Postoperative Complications, Risk Factors, Tachycardia, Ectopic Junctional
Abstract

Junctional ectopic tachycardia (JET) is an arrhythmia observed almost exclusively after open heart surgery in children. Current literature on JET has not focused on patients at the highest risk of both developing and being negatively impacted by JET. The purpose of this study was to determine the overall incidence of JET in an infant patient cohort undergoing open cardiac surgery, to identify patient- and procedure-related factors associated with developing JET, and to assess the clinical impact of JET on patient outcomes. We performed a nested case-control study from the complete cohort of patients at our institution younger than 1 year of age who underwent open heart surgery between 2005 and 2010. JET patients were compared with an age matched control group undergoing open heart surgery without JET regarding potential risk factors and outcomes. The overall incidence of JET in infants after open cardiac surgery was 14.3 %. From multivariate analyses, complete repair of tetralogy of Fallot [adjusted odds ratio (AOR) 2.0, 95 % CI 1.12-3.57] and longer aortic cross clamp times (AOR 1.02, 95 % CI 1.01-1.03) increased the risk of developing JET. Patients with JET had longer length of intubation, intensive care unit stays, and total length of hospitalization, and were more likely to require extracorporeal membrane oxygenation support (13 vs. 4.3 %). JET is a common postoperative arrhythmia in infants after open heart operations. Both anatomic substrate and surgical procedure contribute to the overall risk of developing JET. Developing JET is associated with worse clinical outcomes.

DOI10.1007/s00246-012-0348-y
Alternate JournalPediatr Cardiol
PubMed ID22585344
People: 
David Hanauer
University of Michigan Comprehensive Cancer Center at North Campus Reserach Complex
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Please acknowledge the Cancer Center Support Grant (P30 CA046592) when publishing manuscripts or abstracts that utilized the services of the University of Michigan's Comprehensive Cancer Center's Shared Resource: Cancer Informatics.
Suggested language: "Research reported in this [publication/press release] was supported by the National Cancer Institute of the National Institutes of Health under award number P30CA046592."

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