Incidence and Related Risk Factors of Junctional Ectopic Tachycardia in Infants after Cardiac Surgery for Congenital Heart Disease

Abstract

Objective: Junctional ectopic tachycardia is common after cardiac surgery for congenital heart disease. However, its incidence and related risk factors in infants after cardiac surgery are not well known. The objective of this study was to determine the overall incidence and related risk factors for junctional ectopic tachycardia in neonates and infants. Methods: We enrolled a total of 271 patients aged <1 year who underwent open cardiac surgery at Severance Cardiovascular Hospital from January 2018 to December 2020. Exclusion criteria were immediate postoperative mortality, other arrhythmias detected in the perioperative period, and prematurity. Result: The overall incidence of junctional ectopic tachycardia was 12.9%. The logistic regression analysis revealed that longer cardiopulmonary bypass time, surgery involving atrioventricular node stretching, and the presence of early repolarization on preoperative electrocardiography increased the risk of junctional ectopic tachycardia. Patients with junctional ectopic tachycardia had longer intubation time and intensive care unit stay. Conclusion: Junctional ectopic tachycardia is a common arrhythmia after cardiac surgery for congenital heart disease in infants. Occasionally, infants developing junctional ectopic tachycardia after cardiac surgery have specific preoperative electrocardiography findings. The risk factors for junctional ectopic tachycardia were associated not only with surgical procedural factors but also with preoperative electrocardiographic parameters.