الفهرس 
THE HEARTTHE CONDUCTIION SYSTEM OFOnly 14 pages are availabe for public view
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Abstract
A
SUMMARY
rrhythmias in the immediate postoperative period are a widely recognized complication of cardiothoracic surgery in both the adult and pediatric populations.
Postoperative arrhythmia is a major cause of morbidity and mortality after cardiac surgery for congenital heart disease. Rhythm disturbances that may be well tolerated in a normal heart often cause hemodynamic instability when they occur in the immediate postoperative period.
This study was a prospective, observational study of 30 pediatric patients who underwent open heart operations using cardiopulmonary bypass (CPB).
All cases were subjected to continous ECG monitoring in the ICU, 12 lead ECG, Holler monitoring before discharge.
The aim of this prospective study was to assess the prevalence of early postoperative arrhythmias after cardiac operation in pediatric population, to describe their clinical course, management and to analyze possible risk factors and their outcome.
An arrhythmia was documented in 15 out of 30 patients who represented an overall incidence of 50%. These included 5 patients (33.3%) with JET, 4 (26.67%) with Junctional rhythm (JR), 2 (13.3%) with complete heart block, 2 patients with PVCs, one (6.67%) got attack of SVT and one (6.67%) with ventricular tachycardia.
The cardiac operations with increased risk of early postoperative arrhythmias were total repair of Fallot tetralogy and VSD repair.
The risk factors were younger age, longer cardiopulmonary bypass and ischemic times, inotropic support.
Intravenous amiodarone was effective and relatively safe therapy for postoperative JET in children who fail to respond to conventional treatment or who are hemodynamically unstable. The dosing regimen was a load of 5 mg/kg over 2-4 hours, followed by an infusion of 10-15 mg/kg/day for 48-72 hours.