{"id":3651,"date":"2010-01-10T06:58:34","date_gmt":"2010-01-10T06:58:34","guid":{"rendered":"http:\/\/cardiophile.org\/?p=3651"},"modified":"2023-11-17T08:14:26","modified_gmt":"2023-11-17T02:44:26","slug":"post-operative-arrhythmias-after-chd-surgery","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/post-operative-arrhythmias-after-chd-surgery\/","title":{"rendered":"Postoperative Arrhythmias After Surgery for Congenital Heart Disease"},"content":{"rendered":"<p><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/Fwpg9O4fAUc?si=0GHaTg5Oo80THhK7\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">Postoperative arrhythmias after CHD surgery<\/span><\/h2>\n<p>Postoperative arrhythmias after surgery for congenital heart disease is usually associated with inadequate repair. Electrograms using the pacing wires are useful in arriving at a diagnosis.<\/p>\n<p>Sick sinus syndrome in post op congenital heart disease occurs most often in Fontan and Glenn. Fontan patients tolerate junctional rhythm poorly.\u00a0Atrial flutter can be diagnosed by demonstrating the flutter waves. If the flutter waves are not obvious, adenosine or recording from the atrial pacing wire may be useful.\u00a0Ectopic atrial tachycardia can also be identified by giving adenosine to demonstrate the P waves.\u00a0Sinus node reentrant tachycardia is a long RP tachycardia and resemble ectopic atrial tachycardia. It is adenosine responsive and exquisitely sensitive to digoxin.<\/p>\n<p>Junctional ectopic tachycardia is a major problem in post op period of congenital heart disease. It is a narrow QRS tachycardia with AV dissociation. In those with intact retrograde conduction, AV dissociation will not be there and diagnosis becomes difficult. Fever worsens the rate. JET can be associated with severe hemodynamic consequences and can be lethal.<span style=\"color: #ff00ff;\"> This rhythm does not respond to DC shock<\/span>. Mechanism of post op JET is supposed to be irritation due to local hematoma. Hypothermia is useful in managing this tachycardia. The most useful drugs are amiodarone, procainamide and esmolol.<\/p>\n<p>Ventricular tachycardia is associated with electrolyte abnormalities, inotropes, bad ventricular function or scar based, especially if monomorphic. Overdrive pacing, cardioversion, lignocaine, procainamide or amiodarone may be used. Ventricular fibrillation needs thought of electrolytes as well as coronary compromise. Inadvertent inclusion of coronary arteries in the suture line has to be thought of.\u00a0Alarms due to artefacts are also common in the ICU setting.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Postoperative arrhythmias after CHD surgery usually associated with inadequate repair.<\/p>\n","protected":false},"author":1,"featured_media":37186,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[22,6],"tags":[],"class_list":["post-3651","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiac-surgery","category-ecg-electrophysiology"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Postoperative arrhythmias after CHD surgery - JET is a typical one<\/title>\n<meta name=\"description\" content=\"Postoperative arrhythmias after CHD surgery usually associated with inadequate repair. Junctional ectopic tachycardia is a typical postop arrhythmia.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/post-operative-arrhythmias-after-chd-surgery\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Postoperative arrhythmias after CHD surgery - JET is a typical one\" \/>\n<meta property=\"og:description\" content=\"Postoperative arrhythmias after CHD surgery usually associated with inadequate repair. Junctional ectopic tachycardia is a typical postop arrhythmia.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/post-operative-arrhythmias-after-chd-surgery\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2010-01-10T06:58:34+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-11-17T02:44:26+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/post-operative-arrhythmias-after-chd-surgery\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/post-operative-arrhythmias-after-chd-surgery\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Postoperative Arrhythmias After Surgery for Congenital Heart Disease\",\"datePublished\":\"2010-01-10T06:58:34+00:00\",\"dateModified\":\"2023-11-17T02:44:26+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/post-operative-arrhythmias-after-chd-surgery\\\/\"},\"wordCount\":284,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/post-operative-arrhythmias-after-chd-surgery\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"articleSection\":[\"Cardiac Surgery\",\"ECG \\\/ Electrophysiology\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/post-operative-arrhythmias-after-chd-surgery\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/post-operative-arrhythmias-after-chd-surgery\\\/\",\"name\":\"Postoperative arrhythmias after CHD surgery - JET is a typical one\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/post-operative-arrhythmias-after-chd-surgery\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/post-operative-arrhythmias-after-chd-surgery\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2010-01-10T06:58:34+00:00\",\"dateModified\":\"2023-11-17T02:44:26+00:00\",\"description\":\"Postoperative arrhythmias after CHD surgery usually associated with inadequate repair. 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