Epidemiology
In a multicenter retrospective cohort study involving 7,749 children aged 0-5 years who underwent TOF repair, 1,493 (19%) had codes for tachydysrhythmias [PMID:33735878].
Management
Five infants with refractory JET, treated with oral ivabradine at doses ranging from 0.1 to 0.2 mg/kg/12 h as an adjunct to amiodarone, achieved a heart rate <140 bpm within a mean duration of 16.8 hours and sinus rhythm within 31.6 hours [PMID:31701840].
No patient in the study exhibited hemodynamic derangement or side effects attributable to ivabradine therapy [PMID:31701840].
Complications
Patients with tachydysrhythmias had an inpatient length of stay that was 1.1 days longer compared to those without, accounting for 2% of the variation in LOS [PMID:33735878].
Prognosis & Follow-up
The study found no association between tachydysrhythmias and inpatient mortality among patients who underwent TOF repair [PMID:33735878].
All five patients who received ivabradine remained free of JET recurrence following successful conversion to sinus rhythm [PMID:31701840].
References
1 Ahmed A, Prodhan P, Spray BJ, Bolin EH. Impact of Perioperative Tachydysrhythmias on Mortality and Length of Stay in Complete Repair of Tetralogy of Fallot: A Multicenter Retrospective Cohort Study from the Pediatric Health Information System. Cardiology 2021. link 2 Kumar V, Kumar G, Tiwari N, Joshi S, Sharma V, Ramamurthy R. Ivabradine as an Adjunct for Refractory Junctional Ectopic Tachycardia Following Pediatric Cardiac Surgery: A Preliminary Study. World journal for pediatric & congenital heart surgery 2019. link
2 papers cited of 3 indexed.