Aungkana Gengsakul MD*, James E Potts PhD**, Amonpreet Sandhu MD***, Michael WH Patterson MD, FRCPC**, Suvro S Sett MD, FRCSC****, Glenn Taylor MD*****, Shubhayan Sanatani MD, FRCPC**
* Division of Pediatric Cardiology, Phramongkutklao Hospital,Thailand
** Division of Pediatric Cardiology, *** Department of Pediatrics, **** Division of Cardiothoracic
Surgery, Department of Surgery, ***** Department of Pathology,
British Columbiaûs Childrenûs and Womenûs Hospital, Faculty of Medicine, University of British
Columbia, Vancouver, Canada
Objective : To determine appropriated documentations for diagnosis junctional ectopic tachycardia (JET)
before treatment in post-operative open heart surgery and identify risk factors for post-operative cardiac
arrhythmias in children.
Materials and Methods : The authors performed a retrospective chart review in 277 patients who underwent
surgical corrections at British Columbiaûs Children Hospital from January 1st, 2000 to December 31st ,
2001. History, clinical symptoms, complication of surgery and post-operative cardiac arrhythmias were
reviewed from medical records. The authors investigated whether JET was being diagnosed accurately
and whether it was being adequately documented prior to the initiation of therapy. The authors also
identified risk factors that were associated with JET. All documentations before treatment were reviewed
by Pediatric cardiologists to confirm diagnosis.
Results : Although the diagnostic accuracy (84%), sensitivity (87%), and specificity (84%) are high,
a significant number of patients with post-operative arrhythmias were treated without adequate
documentation of the arrhythmia. The documentation of arrhythmias in the Intensive Care Unit was
largely limited to rhythm strips, with very few 12-lead ECGs and wire studies performed to assist
with the diagnosis.
Conclusion : The presented data indicates that, in this critically-ill population, there was an unacceptable
number of patients with post-operative arrhythmias who may have been treated inappropriately. It is very
important to emphasize the interpretation of wire studies, an investigation normally done in a critical care
setting and whose interpretation is very important to the accurate diagnosis of pediatric arrhythmias
Affiliation :
Post-operative arrhythmia, Junctional ectopic tachycardia, Congenital heart disease, Atrial wire study, ECG, Diagnosis
Keywords :
