Clinical InvestigationAnalysis of clinical and candidate genetic risk factors for postoperative atrial tachycardia after congenital heart surgery in infants
Section snippets
Methods
This study used an ongoing observational cohort study of children enrolled at the time of cardiac surgery for CHD. Children <1 year of age and undergoing their first surgery for CHD at Monroe Carell Jr Children's Hospital at Vanderbilt between September 2007 and May 2016 who consented to the study were included. The Institutional Review Board at Vanderbilt University Medical Center approved this study. Written consent was obtained from parents or legal guardians. Patients whose parents or
Results
A total of 1,067 infants with a median age of 2 months (interquartile range 0.3-5.1) were included in our study. Characteristics of the entire study cohort are listed in Table I. Overall operative mortality was 6.3%, and median duration of ventilation, ICU stay, and hospital stay were 2, 6, and 11 days, respectively. A total of 167 patients (15.4%) developed AT at a median of 5 days postoperatively (interquartile range 2-8 days). Patients who developed AT were younger and had higher surgical
Discussion
In this cohort of more than 1,000 infants undergoing CHD surgery, we observed AT in 15.4% and identified a number of clinical risk factors independently associated with AT, including use of 2 or more inotropes, higher surgical complexity score, neonatal age at surgery, and cardiopulmonary bypass time. We also investigated 2 common genetic variants in PITX2 and IL6 which have been associated with postoperative AF in adults, but found no association with postoperative AT in infants. Patients with
Conclusions
In conclusion, AT occurs in 15% of infants after congenital heart surgery and is associated with increased morbidity and mortality. Risk factors for AT include use of 2 or more inotropes, neonatal age at surgery, and higher surgical complexity score. We found no association between common genetic variants in PITX2 and IL6 and AT in infants after congenital heart surgery.
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