Early arrhythmia after cardiac surgery in children with congenital heart disease

Objective. To analyze the frequency and risk factors for arrhythmia in children with congenital heart disease in the early period after cardiac surgery. Materials and methods. A retrospective analysis of the incidence and risk factors for arrhythmia in 285 children who underwent cardiac surgery in the Department of Surgical Treatment of Congenital Heart Diseases in Newborns and Young Children at the Amosov National Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine for the period from 2021 to 2023 was performed. There were 202 children under the age of 18. Results. In the early postoperative period, heart rhythm disturbances occurred in 53 (26.2%) of 202 patients: 28 had supraventricular tachycardia, 16 had bradyarrhythmia (atrioventricular block), 6 had ventricular tachycardia, and 3 had nodal ectopic tachycardia. It was found that plastic surgery of the interventricular and atrial septal defect in isolation or in combination with interventions for other defects (Fallot's tetrad, transposition of the great vessels, atrioventricular communication) and bidirectional and total cavopulmonary anastomoses are associated with a high risk of arrhythmia. Statistically significant (p < 0.05) risk factors for arrhythmia were: lactate level of more than 2 mmol/L, duration of cardiopulmonary bypass more than 185 minutes, duration of aortic clamping more than 67 minutes. Conclusions. Arrhythmia often complicates the course of the early period after cardiac surgery in children and requires timely and correct action. Prolonged cardiopulmonary bypass, aortic constriction, and lactatidosis are risk factors for arrhythmia. Plastic surgery of the interventricular and atrial septal defects, as well as palliative reconstructive heart surgery, are associated with frequent cardiac arrhythmias in the early postoperative period.