Association of temporary complete AV block and junctional ectopic tachycardia after surgery for congenital heart disease

Ann Pediatr Cardiol. 2015 Jan-Apr;8(1):14-9. doi: 10.4103/0974-2069.149513.

Abstract

Aim: Junctional ectopic tachycardia (JET) is a postoperative complication with a mortality rate of up to 14% after surgery for congenital heart disease. This study evaluated the risk factors of JET and explored the association of postoperative temporary third degree atrioventricular (AV) block and the occurrence of JET.

Materials and methods: Data were collected retrospectively from 1158 patients who underwent surgery for congenital heart disease.

Results: The overall incidence of JET was 2.8%. Temporary third degree AV block occurred in 1.6% of cases. Permanent third degree AV block requiring pacemaker implantation occurred in 1% of cases. In all, 56% of patients with JET had temporary AV block (P < 0.001), whereas no case of postoperative JET was reported in patients with permanent AV block (P = 0.56). temporary third degree AV block did not suffer from JET.

Conclusions: A correlation between temporary third degree AV block and postoperative JET could be observed. The risk factors identified for JET include younger age groups at the time of surgery, longer aortic cross clamping time and surgical procedures in proximity to the AV node.

Keywords: AV block; congenital heart disease; heart block; junctional ectopic tachycardia.