Mahdavi Chehreh, Sabri Mohammad Reza, Ahmadi Alireza, Ghaderian Mehdi, Bigdelian Hamid, Dehghan Bahar, Ramezani Nezhad Davood, Sadat Salamati Ladan, Bamarinejad Atefeh, Bamarinejad Fatemeh, Mirsaidi Mobina Haji
Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Cardiovascular Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Tehran Heart Cent. 2024;19(Suppl 1):17-23. doi: 10.18502/jthc.v19is1.18475.
Complete heart block (CHB) is a known complication of congenital heart disease (CHD) corrections in children. However, data on the prevalence and short-term outcomes of postprocedural CHB in this population are scarce.
This study aimed to investigate the prevalence and short-term outcomes of postprocedural CHB in pediatric patients undergoing surgical or transcatheter procedures to correct CHD.
A retrospective cohort study was conducted on pediatric patients under 18 years old who underwent CHD corrections between March 2019 and April 2020 at a tertiary cardiac center in Isfahan, Iran. Patients with a history of arrhythmia or heart block before surgery were excluded. The medical records of these patients were reviewed to identify cases of postprocedural CHB. The prevalence, risk factors, and short-term outcomes of postprocedural CHB were analyzed.
This study involved 840 patients with a mean age of 3.4 ± 4.3 years, with 47.8% being male. CHB was identified in 22 patients (2.6%) during the postprocedural period, with a prevalence of 0.6% in the transcatheter group and 4.7% in the surgical group. Patients with postprocedural CHB were younger than non-CHB patients. The most common CHDs were patent ductus arteriosus and ventricular septal defect (VSD). Univariate and multivariate regression analyses showed that the type of procedure (surgical method) and the type of CHD (VSD) correlated with postprocedural CHB. Patients who developed postprocedural CHB had a longer mean stay in the pediatric cardiac critical care unit than non-CHB patients. The postoperative in-hospital mortality rate was 5.2%, with no correlation between CHB occurrence and in-hospital mortality.
The findings highlight the importance of attentive monitoring for postprocedural CHB, particularly in younger patients, to facilitate timely intervention and improve outcomes. Further research is warranted to explore the long-term complications and risk factors associated with postprocedural CHB in this patient population.
完全性心脏传导阻滞（CHB）是儿童先天性心脏病（CHD）矫正术后已知的并发症。然而，关于该人群术后CHB的患病率和短期结局的数据却很稀少。
本研究旨在调查接受手术或经导管手术矫正CHD的儿科患者术后CHB的患病率和短期结局。
对2019年3月至2020年4月在伊朗伊斯法罕一家三级心脏中心接受CHD矫正的18岁以下儿科患者进行了一项回顾性队列研究。排除术前有心律失常或心脏传导阻滞病史的患者。查阅这些患者的病历以确定术后CHB病例。分析术后CHB的患病率、危险因素和短期结局。
本研究纳入了840例患者，平均年龄为3.4±4.3岁，其中47.8%为男性。术后期间有22例患者（2.6%）被诊断为CHB，经导管组患病率为0.6%，手术组为4.7%。术后发生CHB的患者比未发生CHB的患者年龄更小。最常见的CHD是动脉导管未闭和室间隔缺损（VSD）。单因素和多因素回归分析表明，手术类型（手术方法）和CHD类型（VSD）与术后CHB相关。发生术后CHB的患者在儿科心脏重症监护病房的平均住院时间比未发生CHB的患者更长。术后住院死亡率为5.2%，CHB的发生与住院死亡率之间无相关性。
研究结果强调了对术后CHB进行密切监测的重要性，特别是对较年轻的患者，以便及时进行干预并改善结局。有必要进一步研究探索该患者群体中与术后CHB相关的长期并发症和危险因素。
