HEART ARRHYTHMIAS AND DISORDERS OF CONDUCTION AS COMPLICATION OF
FALLOT'S TETRALOGY IN CHILDREN AFTER CARDIAC SURGERY
Polecka B, Chrzastek-Spruch
H, Sadurska E, Stazka-Gregosiewicz E, Jawniak R
Department of
Paediatrics, Medical University School of Lublin, Poland
Objective: To evaluate the frequency of
postoperative disorders in the heart rhythm and/or conduction in children
with tetralogy of Fallot.
Method: 30 children aged 5mths to 14yrs 6 mths with
tetralogy of Fallot who underwent cardiosurgery were ECG monitored round
the clock by Holter's method.
Results: 24h-ECG monitoring found: 1. total or partial
right branch His's bundle block (RBBB) in 27 children (90%), 2. 1st-3rd
degree block in 3 children (3rd degree block required the
implantation of a pace-maker), 3. in the early postoperative period one
child suffered from paroxismal supraventricular tachycardia followed by
single premature supraventricular and ventricular beats as well as
atrio-ventricular block of 2nd degree, 4. one child had atrial
tachycardia which went away completely without irregularity of the heart
rhythm, 5. in one child during the first half of the year following the
surgery episodes of ventricular tachycardia occurred.
Conclusions: 1.Children with tetralogy of Fallot
surgically corrected most often develop disorders of conduction, which take
the form of RBBB. 2. All children with tetralogy of Fallot surgically
corrected need continuous electrocardiographic monitoring because of
considerably frequent arrhythmias and/or disturbance of conduction and
threat of sudden death from ventricular tachycardia.