Postoperative junctional ectopic tachycardia in children: incidence, risk factors, and treatment

Hoffman, Timothy M.; Bush, David M.; Wernovsky, Gil; Cohen, Mitchell I.; Wieand, Tammy S.; Gaynor, J. William; Spray, Thomas L.; Rhodes, Larry A.

doi:10.1016/s0003-4975(02)04014-6

Cited by 178 publications

(154 citation statements)

References 23 publications

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“…(range 1 to 50 days; median, 1 day) and 3 patients experienced JET greater than one week (18). Incidence of postoperative JET decreased from 10% to 2% with a close temporal association of a modification in surgical technique in our study.…”

Section: Discussionsupporting

confidence: 53%

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Cardiopulmonary Bypass Surgery in Children - Minimizing the Incidence of Postoperative Junctional Ectopic Tachycardia after Surgical Technique Modification

Azhar¹,

Arabia²

2012

Am. J. Biomed. Sci.

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Background: Mechanical injury to tissues in and surrounding the Atrioventricular node is considered a major factor in the aetiology of postoperative Junctional Ectopic Tachycardia (JET).Objectives: The study aims to evaluate the effect of retractor modification used during cardiopulmonary bypass surgery and the incidence of postoperative JET in children.Material & Methods: The study involves retrospective chart review of all pediatric patients who had undergone cardiopulmonary bypass surgery in Children Hospital of Eastern Ontario, Canada, between 1993 and 1996. Patients treated between 1993 to 1994 with wide eyelid retractor (depth 23mm; width 18 mm) were classified as Group A, and the patients treated with narrow retractor (depth 10 mm; width 8 mm) between 1995 to 1996 were classified as Group B, respectively.Results: Of the study subjects, Group A had 209 while Group B had 186 subjects. The age and weight of group A subjects was "mean ± standard deviation" (4.4±4.1 year and 17±12 kg), while that of Group B was (4.7±4.7 year and 20±15 kg). The overall incidence of postoperative JET and mortality was lower in Group B than Group A (2% vs. 10%; p=0.0008; 0% vs. 21%; p<0.05, respectively).Conclusion: A decrease in the incidence of JET and mortality was noticed after the use of narrow retractor.

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Section: Discussionsupporting

confidence: 53%

“…However, JET was still noted in some patients who did not undergo operations near the atrioventricular node or intracardiac surgical procedure. Additionally, there was also no association found between electrolyte disturbances and JET within 72 hours after operation (18).…”

Section: Discussionmentioning

confidence: 80%

Cardiopulmonary Bypass Surgery in Children - Minimizing the Incidence of Postoperative Junctional Ectopic Tachycardia after Surgical Technique Modification

Azhar¹,

Arabia²

2012

Am. J. Biomed. Sci.

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“…JET occurred in 22% of Tetralogy of Fallot (TOF) repairs, 10% of atrio-ventricular septal defect repairs, and 3.7% of VSD repairs (Dodge-Khatami et al 2002). Predictors of post-operative JET were younger age (Hoffman et al 2002), lower body weight (Rekawek et al 2007), resection of muscle bundles, higher bypass temperatures, and relief of right ventricular outflow tract obstruction through the right atrium (Dodge-Khatami et al 2002). 7.1.3 Mechanism: Although the mechanism of JET is unclear, abnormal (enhanced) automaticity of the junction has been put forth.…”

Section: Junctional Tachy-arrhythmiasmentioning

confidence: 99%

Arrhythmias in Children and Young Adults

Singh¹

2012

Advances in Electrocardiograms - Clinical Applications

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“…Automatic rhythms originating from the zone near the AV junction can prove to be particularly troublesome, particularly in the postoperative period. Hoffman et al [5] examined the factors contributing to postoperative junctional ectopic tachycardia (JET) in their institution and found an overall incidence of 5.6% for all patients undergoing cardiac surgery. Dopamine or milrinone infusions, longer cardiopulmonary bypass times, and younger patient age were all associated with the presence of junctional tachycardia.…”

Section: Mechanisms Of Supraventricular Tachycardiamentioning

confidence: 99%

Advances in the approach to treatment of supraventricular tachycardia in the pediatric population

Chun

Hare²

2004

Curr Cardiol Rep

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Supraventricular tachycardia is relatively common in children. Although most forms are not life threatening, treatment options depend on appropriate diagnosis. In certain patients, medical treatments are adequate for controlling symptoms. For those in whom medical therapy is inadequate or undesirable, invasive electrophysiology techniques are a viable treatment option. Increasing experience with radiofrequency catheter ablation techniques has led to improved success rates and decreased complication rates. New technologies, such as nonradiographic mapping systems and novel ablation catheters, are additional tools that can improve the ability of pediatric electrophysiologists to approach treating tachycardia mechanisms that have previously been too challenging to treat safely.

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Postoperative junctional ectopic tachycardia in children: incidence, risk factors, and treatment

Cited by 178 publications

References 23 publications

Cardiopulmonary Bypass Surgery in Children - Minimizing the Incidence of Postoperative Junctional Ectopic Tachycardia after Surgical Technique Modification

Cardiopulmonary Bypass Surgery in Children - Minimizing the Incidence of Postoperative Junctional Ectopic Tachycardia after Surgical Technique Modification

Arrhythmias in Children and Young Adults

Advances in the approach to treatment of supraventricular tachycardia in the pediatric population

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