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Title: Junctional ectopic tachycardia following repair of congenital heart defects - experience in multimodal management from a west african centre.
Authors: Entsua-Mensah, K.
Aniteye, E.
Sereboe, L.A.
Tettey, M.M.
Edwin, F.
Tamatey, M.
Delia, I.
Gyan, K.B.
Keywords: Amiodarone; Congenital; Direct current shock; Heart defects; Junctional ectopic tachycardia; Magnesium sulphate; Multimodal management
EMTREE drug terms: amiodarone; inotropic agent; magnesium sulfate
EMTREE medical terms: Africa; anesthesia; body weight; cardioversion; child; congenital heart malformation; coronary artery bypass graft; disease control; drug infusion; electric shock; electrocardiogram; fever; follow up; hospital admission; human; incidence; intensive care unit; junctional ectopic tachycardia; major clinical study; medical record review; open heart surgery; outpatient care; palliative therapy; patient information; recurrent disease; retrospective study; review; sinus rhythm; tachycardia; treatment outcome
Issue Date: 2012
Citation: Entsua-Mensah, K., Aniteye, E., Sereboe, L. A., Tettey, M. M., Edwin, F., Tamatey, M., . . . Gyan, K. B. (2012). Junctional ectopic tachycardia following repair of congenital heart defects - experience in multimodal management from a west african centre. Pan African Medical Journal, 12(1).
Abstract: Background: Postoperative junctional ectopic tachycardia (JET) is a rare and transient phenomenon occurring after repair of congenital heart defects. Report on this arrhythmia in the subregion is rare. We set out to determine the incidence of this arrhythmia and review the treatment and outcomes of treatment in our centre. Methods: Retrospective search of the records of all patients aged 18 years and below admitted into the intensive care unit (ICU) following repair or palliation of a congenital heart defect over 5 years, from January 1, 2006 to December 31, 2010. A review of clinical notes, operative records, anaesthetic charts, cardiopulmonary bypass (CPB) records, nursing observation charts, electrocardiograms (ECGs) and out-patient follow-up records was undertaken. Results: 510 children under 18 years were enlisted. 7 cases of postoperative JET were recorded, (1.37%). 184 (36.1%) of these were performed under CPB. All JET cases were from cases done under CPB, 3.8%. Median age was 3 years and median weight 11.3kg. No patient was febrile at diagnosis. 4 patients had amiodarone administration, 5 had magnesium sulphate infusion, 2 patients had direct current shock (DCS) whilst 3 patients had all three therapeutic modalities. All patients had control of the arrhythmia with conversion to sinus rhythm and no recurrence. Conclusion: We report a JET incidence of 1.37% among children undergoing CPB for repair of congenital heart defects. We demonstrate the therapeutic effectiveness of amiodarone, magnesium sulphate infusions and DCS alone or in combination in the management of JET on various substrates with good outcome.
ISSN: 19378688
Appears in Collections:Department of Anaesthetics 9

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