Postoperative Atrioventricular Block in Pediatric Patients: Impact of Congenital Cardiac Malformations and Medications.

Document Type

Article

Publication Date

4-2024

Identifier

DOI: 10.1007/s00246-024-03427-7

Abstract

Postoperative atrioventricular block may occur after pediatric cardiac surgery. A small proportion of those who develop atrioventricular block will require pacemaker placement. The primary aim of this study was to determine factors associated with postoperative atrioventricular block. Secondary aims included determining factors associated with pacemaker placement in those with atrioventricular block. Data from the PHIS data were utilized to identify patients under 18 years of age who underwent cardiac surgery. Those who did and did not develop atrioventricular block. Univariable analyses and regression analyses were conducted to determine factors associated with postoperative atrioventricular block. Similar analyses were conducted to determine factors associated with pacemaker placement in those with atrioventricular block. A total of 43,716 admissions were identified. Of these, 2093 (5%) developed atrioventricular block and 480 (1% of total admissions) underwent pacemaker placement. Approximately 70% of those with atrioventricular block received steroids but this was not associated with a decrease in pacemaker placement. Risk factors (congenital malformations of the heart, comorbidities, medications) associated with increased risk of atrioventricular block and pacemaker placement were identified. Postoperative atrioventricular block occurred in 5% of pediatric admissions for cardiac surgery. Of these admissions with postoperative atrioventricular block, 23% required pacemaker placement. Isoproterenol and steroids were not associated with a reduction in the likelihood of pacemaker placement.

Journal Title

Pediatric cardiology

Volume

45

Issue

4

First Page

759

Last Page

769

MeSH Keywords

Child; Humans; Adolescent; Atrioventricular Block; Pacemaker, Artificial; Cardiac Surgical Procedures; Heart Defects, Congenital; Postoperative Complications; Steroids

Keywords

Atrioventricular block; Block; Congenital heart disease; Heart.

Library Record

Share

COinS