Massin M, Malekzadeh-Milani S G, Demanetz H, Wauthy P, Deuvaert F E, Dessy H, Verbeet T
Division of Paediatric Cardiology at Queen Fabiola Children's University Hospital (HUDERF), Brussels, Belgium.
Acta Clin Belg. 2010 Nov-Dec;65(6):386-91. doi: 10.1179/acb.2010.65.6.003.
BACKGROUND; Our aim was to determine the incidence, risk factors and outcome of early postoperative arrhythmias in children with delayed treatment of severe congenital heart disease.
A prospective study was conducted in 141 consecutive children with delayed referral from emerging countries, who underwent open-heart surgery.
Sinus node dysfunction was noted in 5 cases. Preoperative moderate extrasystoly was common and its incidence significantly increased in the postoperative phase. Overall, 9 patients required specific antiarrhythmic therapy: 6 for sustained atrioventricular reciprocating tachycardia, and 3 respectively for atrial flutter, atrial fibrillation and junctional ectopic tachycardia. Non-sustained atrioventricular and ventricular tachycardia required no therapy in respectively 6 and 1 case. Postoperative complete atrioventricular block was observed in 6 patients and remained permanent in 3. No major complications resulted from those arrhythmias. Preoperative low oxygen saturation, preoperative arrhythmias, as well as long cardiopulmonary bypass time and aortic cross-clamp time, were risk factors for early postoperative arrhythmias.
Children with delayed surgery for congenital heart disease are at risk of developing early postoperative arrhythmias depending on the complexity of their disease and of its treatment. However, their prevalence (14%) is not higher than in the general population of cardiac children.
背景；我们的目的是确定严重先天性心脏病延迟治疗患儿术后早期心律失常的发生率、危险因素及转归。
对141例来自新兴国家转诊延迟且接受心脏直视手术的患儿进行前瞻性研究。
5例出现窦房结功能障碍。术前中度早搏常见，术后发生率显著增加。总体而言，9例患者需要特定的抗心律失常治疗：6例用于持续性房室折返性心动过速，3例分别用于心房扑动、心房颤动和交界性异位性心动过速。非持续性房室性和室性心动过速分别有6例和1例无需治疗。6例患者术后出现完全性房室传导阻滞，3例持续存在。这些心律失常未导致重大并发症。术前低氧饱和度、术前心律失常以及较长的体外循环时间和主动脉阻断时间是术后早期心律失常的危险因素。
先天性心脏病延迟手术的患儿术后早期有发生心律失常的风险，这取决于疾病及其治疗的复杂性。然而，其发生率（14%）并不高于心脏疾病患儿的总体发生率。
