Risk factors for faulty rhythms

Arrhythmias—disruptions in the rhythm of the heartbeat—after congenital heart disease (CHD) surgery in children are common and contribute to increased morbidity and mortality.

Prince Kannankeril, MD, MSCI, and colleagues explored clinical and genetic factors associated with atrial tachycardia (AT) after CHD surgery in infants younger than 1 year old. They examined variants in the genes PITX2 and IL6, which are associated with postoperative atrial fibrillation in adults after cardiac surgery.

The investigators reported in the August issue of American Heart Journal that 15 percent of infants enrolled in the study experienced AT after CHD surgery. AT was associated with need for extracorporeal membrane oxygenation (ECMO) support and longer duration of ventilation, intensive care unit stays, and hospital stays. Variations in PITX2 and IL6 were not associated with postoperative AT.

Risk factors for AT included the use of two or more inotropes (drugs that increase the force of the heart's contraction), neonatal age less than 28 days at surgery, and higher surgical complexity scores.