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- W3186161124 abstract "Junctional ectopic tachycardia (JET) is a common postoperative arrhythmia associated with morbidity and mortality. Studies suggest that peri-operative treatment may improve outcomes (dexmedetomidine, magnesium, amiodarone), but patient selection remains a challenge. To develop a risk-prediction score to identify patients at highest risk of post-operative accelerated junctional rhythm (AJR) and JET. Retrospective study of children 0-18 years undergoing cardiac surgery between 2011-2018. AJR and JET were defined as usual complex tachycardia with > 1:1 ventricular-atrial association and rates > 100 bpm and >170 bpm respectively. AJR/JET was identified on 12-lead ECG and/or hourly nursing rhythm assessment; all cases were reviewed and validated. A risk prediction model was developed using random forest analysis and logistic regression. From 6369 surgeries, AJR occurred in 181 (3%) and JET in 39 (0.6%). Age, heterotaxy syndrome, aortic cross-clamp time (CC), ventricular septal defect closure and atrioventricular canal repair were independent predictors of postoperative AJR/JET on multivariate analysis and included in the risk prediction score (Hosmer-Lemeshow 0.36, C-index of 0.72 [95% CI 0.70, 0.75]). Partial dependency plots showed co-dependence between CC time and age, with longer CC time affecting younger children more significantly than older children (Figure). This novel risk score can be used to predict the risk of postoperative AJR/JET. The early identification of patients at highest risk may provide an opportunity for prophylactic intervention to decrease the risk and improve outcomes." @default.
- W3186161124 created "2021-08-02" @default.
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- W3186161124 date "2021-08-01" @default.
- W3186161124 modified "2023-10-16" @default.
- W3186161124 title "B-PO02-198 PREDICTING POST-OPERATIVE ACCELERATED JUNCTIONAL RHYTHM AND JUNCTIONAL ECTOPIC TACHYCARDIA: OPPORTUNITY FOR PREVENTION?" @default.
- W3186161124 doi "https://doi.org/10.1016/j.hrthm.2021.06.450" @default.
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