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Post-operative arrhythmias in patients with hypoplastic left heart syndrome and anatomic variants: incidence, type, and course

Part of: Interventional Cardiology

Published online by Cambridge University Press:  09 March 2021

Muluneh A. Yimer Open the ORCID record for Muluneh A. Yimer [Opens in a new window] ,
Svjetlana Tisma-Dupanovic ,
Lindsey Malloy-Walton ,
Diana Connelly ,
Janelle Noel-Macdonnell ,
James O’ Brien  and
John Papagiannis
Muluneh A. Yimer*
Affiliation:
Children’s Mercy Hospital, Ward Family Heart Center, Department of pediatric cardiology, 2401 Gillham Road, Kansas City, MO64108, USA
Svjetlana Tisma-Dupanovic
Affiliation:
Children’s Mercy Hospital, Ward Family Heart Center, Department of pediatric cardiology, 2401 Gillham Road, Kansas City, MO64108, USA
Lindsey Malloy-Walton
Affiliation:
Children’s Mercy Hospital, Ward Family Heart Center, Department of pediatric cardiology, 2401 Gillham Road, Kansas City, MO64108, USA
Diana Connelly
Affiliation:
Children’s Mercy Hospital, Ward Family Heart Center, Department of pediatric cardiology, 2401 Gillham Road, Kansas City, MO64108, USA
Janelle Noel-Macdonnell
Affiliation:
Children’s Mercy Hospital, Ward Family Heart Center, Department of pediatric cardiology, 2401 Gillham Road, Kansas City, MO64108, USA
James O’ Brien
Affiliation:
Children’s Mercy Hospital, Ward Family Heart Center, Department of pediatric cardiology, 2401 Gillham Road, Kansas City, MO64108, USA
John Papagiannis
Affiliation:
Children’s Mercy Hospital, Ward Family Heart Center, Department of pediatric cardiology, 2401 Gillham Road, Kansas City, MO64108, USA
*
Author for correspondence: Dr M. A. Yimer, MD, Capital Pediatric Cardiology. 2929 K Street, Ste 200, Sacramento, CA 95816, USA. Tel: +925 360 1876; Fax: +916 710-8113. E-mail: mulunehyimermd@gmail.com
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Abstract

Background:

Arrhythmias are common in the post-operative course of patients with hypoplastic left heart syndrome. We sought to determine the types, incidence, risk factors, and impact of arrhythmias in patients with HLHS and anatomic variants.

Methods:

We performed a retrospective chart review of 120 consecutive patients with HLHS and anatomical variants, who had single-ventricle palliation at our institution from January, 2006 to December, 2016.

Results:

A total of thirty-one patients (26%) had 37 episodes of arrhythmias over a median follow-up period of 3.5 years. Of the 37 episodes, 12 (32.4%) were ectopic atrial tachycardia, 9 (24.3%) were paroxysmal supraventricular tachycardia, 4 (10.8%) were junctional ectopic tachycardia, 5 (13.6%) were sinus node dysfunction, 3 (8.1%) were heart block, 2 (5.4%) were atrial flutter, and 2 (5.4%) were ventricular tachycardia. Twenty-four (65%) of the arrhythmias occurred at post-stage 1 surgery. Most (64.8%) of the arrhythmias were resolved. Arrhythmias that occurred at post-stage 1 surgery were more likely to resolve compared to post-stages 2 or 3 (p = 0.006). No anatomical, surgical, or clinical variables were associated with arrhythmia except for age (OR per unit decrease in age at stage 1 palliation: 1.12 (95% CI 1.003, 1.250); p = 0.0439). Arrhythmias were not associated with length of hospital stay or mortality.

Conclusion:

Arrhythmias are common in patients with HLHS and anatomic variants, with EAT and PSVT being the most common types. Arrhythmias were associated with younger age at surgery, but did not affect mortality or length of hospital stay.

Keywords

Post-operative arrhythmiasarrhythmiasectopic atrial tachycardiasupraventricular tachycardiahypoplastic left heart syndromesingle-ventricle palliation
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 9 , September 2021 , pp. 1412 - 1418
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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