Benítez RDB, Cabrera OM, Lambert MJM, Bravo POL, Machado SO, Naranjo UA, González GA, Barrial MJ

Language: Spanish
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ABSTRACT

Introduction: postoperative arrythmias after correction of congenital heart diseases showed an incidence rate of 15 to 48 %. They are related to the surgical technique used and increase the morbidity and mortality during the immediate postoperative period.
Objective: to estimate the incidence of arrythmias in the early postoperative period of congenital heart diseases as well as their risk predictors.
Methods: a prospective, observational and analytical study of patients with corrected congenital heart diseases in "William Soler" pediatric cardiocenter. The following variables were analyzed: age, weight, heart disease, RACHS risk scale, type of correction, time of extracorporeal circulation, time of aortic pinching, use of hypothermia, index of inotropics and levels of serum electrolytes.
Results: of 1 200 patients, 162 (13.5 %) presented with postoperative arrythmias and the most frequent ones are junctional ectopic tachycardia (5.4 %) and atrioventricular blocking (3.9 %). By means of the univariate analysis, the identified risk factors were the age of 12 months or younger (p= 0.026), time of extracorporeal circulation (p= 0.003) and aortic pinch (p= 0.0001), surgeries associated to the AVHis bundle node and RACHS risk scale values equal or higher than 2 (p= 0.018). In the multivariate analysis, the time of aortic pinch (odds ratio= 8.4; p< 0.001) and the surgeries related to AV node-His bundle (odds ratio= 10.2; p< 0.001) were statistically significant.
Conclusions: arrythmias are common in the early postoperative period after correction of congenital heart diseases. The time of aortic pinch and the surgeries involving the AV-His bundle node area are risk predictors for the development of heart rate disorders.