Dysrhythmias after atrial surgery in children

Repaired and open atrial septal defects type II in adulthood: An epidemiological study of a large European cohort

“…The greater prevalence of sick sinus node syndrome among the operated patients is probably attributable to a direct effect of the surgery itself, although it cannot be excluded that the finding is due to selection bias (see above). Occurrence of sick sinus node syndrome after surgical ASD closure has been described previously, and has been linked to particularities of the surgical technique used (cannulation and suturing in the sinus node area) [15]. Whether or not device closure will be more effective in preventing arrhythmia's cannot be evaluated on the basis of this study.…”

Clinical Exercise Testing in Children

“…Damage to the SA nodal artery during cannulation for heart-lung bypass, direct damage to the SA node or its artery during the surgical repair, and part of the natural history of the disease have all been implicated. Maximal heart rates in the range of 140-160 beats/min are seen and can obviously contribute to or be responsible for exercise limitation [75][76][77]. As noted above, it is also possible to utilize submaximal and novel approaches to exercise testing in order to gain useful information regarding underlying pathophysiology in children with congenital heart disease [32].…”

“…Open-heart surgery to repair congenital cardiac defects leaves a surgical scar on either the right atrium or right ventricle, and may be a potential source of arrhythmias for these patients [76,77,87,88]. The arrhythmia potential is increased if there is any residual hemodynamic burden on the myocardium.…”

Pharmacologic Management of Arrhythmias in Patients with Congenital Heart Disease

“…Acute-onset sinus bradycardia may be a manifestation of intrinsic SND or be secondary to severe hypoxia and acidosis. [5] Chronic SND is primarily observed following surgical procedures involving the atrium, such as after atrial septal defect (ASD) closure, [6] the Fontan operation (cavo-pulmonary connection) for univentricular physiology, [7] or the Mustard and Senning procedure (atrial switch) for transposition of the great arteries. [8] Wittig et al [9] demonstrated that, in addition to SND, profound changes in intra-atrial conduction occur following surgery.…”

“…The goals of treatment goal are to re-establish sinus rhythm or to decrease the rate of the tachycardia to a point where atrial pacing can be performed, which will restore AV synchrony. Factors such as electrolyte Patients free of recurrence (%) 6 1 2 1 8 2 4…”