Document Detail


Junctional ectopic tachycardia after congenital heart surgery.
MedLine Citation:
PMID:  24988822     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE: In this literature review, we try to give anesthesiologists a better understanding about Junctional Ectopic Tachycardia (JET), a narrow complex tachycardia that frequently occurs during and after surgery for congenital heart disease.
SOURCE: Information was found in the databases of Pubmed, Science Direct, Medline and the Cochrane Library, by using the mesh terms "Tachycardia, Ectopic Junctional", combined with "Diagnosis", "Etiology", "Physiopathology", "Complications" and "Therapy". The publication date of the articles ranged from 1990 to 2012.
PRINCIPAL FINDINGS: Risk factors for the development JET are surgery near the AV node, a duration of cardiopulmonary bypass longer than 90 minutes, young age, the use of inotropic drugs and hypomagnesaemia. The diagnosis of Junctional Ectopic Tachycardia can be made on a 12-lead ECG, demonstrating a narrow-complex tachycardia with inverted P-waves and VA dissociation. Adenosine administration and an atrial electrocardiogram can help to confirm the diagnosis. If JET has a minimal impact on the hemodynamic status of the patient, risk factors should be avoided and the adrenergic tonus should be reduced. Hemodynamic unstable JET can be treated by amiodarone, hypothermia and pacing. Extracorporeal membrane oxygenation (ECMO) and radiofrequency or cryoablation are treatment options for life-threatening and resistant JET.
CONCLUSION: JET is the most frequent arrhythmia during and after congenital cardiac surgery. The ECG is the only available method to diagnose JET, demonstrating inverted P-waves and VA-dissociation. Amiodarone seems to be the most effective treatment option, because it can restore sinus rhythm and reduces the JET rate.
Authors:
E Cools; C Missant
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta anaesthesiologica Belgica     Volume:  65     ISSN:  0001-5164     ISO Abbreviation:  Acta Anaesthesiol Belg     Publication Date:  2014  
Date Detail:
Created Date:  2014-07-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421022     Medline TA:  Acta Anaesthesiol Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  1-8     Citation Subset:  IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Self-report of diabetes and claims-based identification of diabetes among Medicare beneficiaries.
Next Document:  Hydroxyethyl starches in the perioperative period. A review on the efficacy and safety of starch sol...