Prevalence and Short-Term Outcomes of Postprocedural Complete Heart Block in Congenital Heart Disease Correction in Children

Chehreh  Mahdavi; Mohammad Reza  Sabri; Alireza  Ahmadi; Mehdi  Ghaderian; Hamid  Bigdelian; Bahar  Dehghan; Davood Ramezani  Nezhad; Atefeh  Bamarinejad; Fatemeh  Bamarinejad; Mobina Haji  Mirsaidi

doi:10.18502/jthc.v19is1.18475

Chehreh Mahdavi Assistant Professor of Pediatric Cardiology, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Mohammad Reza Sabri Professor of Pediatric Cardiology, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Alireza Ahmadi Professor of Pediatric Cardiology, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Mehdi Ghaderian Associate Professor of Pediatric Cardiology, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Hamid Bigdelian Associate Professor of Congenital Cardiac Surgery, Department of Cardiovascular Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Bahar Dehghan Assistant Professor of Pediatric Cardiology, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Davood Ramezani Nezhad Assistant Professor of Pediatric Cardiology, Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Atefeh Bamarinejad Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Fatemeh Bamarinejad Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Mobina Haji Mirsaidi Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

DOI: https://doi.org/10.18502/jthc.v19is1.18475

Keywords: Complete heart block; Congenital heart disease; Pediatric; Postprocedural; Surgical correction

Abstract

Background: Complete heart block (CHB) is a known complication of congenital heart disease (CHD) corrections in children. However, data on the prevalence and short-term outcomes of postprocedural CHB in this population are scarce.

Objectives: This study aimed to investigate the prevalence and short-term outcomes of postprocedural CHB in pediatric patients undergoing surgical or transcatheter procedures to correct CHD.

Method: A retrospective cohort study was conducted on pediatric patients under 18 years old who underwent CHD corrections between March 2019 and April 2020 at a tertiary cardiac center in Isfahan, Iran. Patients with a history of arrhythmia or heart block before surgery were excluded. The medical records of these patients were reviewed to identify cases of postprocedural CHB. The prevalence, risk factors, and short-term outcomes of postprocedural CHB were analyzed.

Result: This study involved 840 patients with a mean age of 3.4 ± 4.3 years, with 47.8% being male. CHB was identified in 22 patients (2.6%) during the postprocedural period, with a prevalence of 0.6% in the transcatheter group and 4.7% in the surgical group. Patients with postprocedural CHB were younger than non-CHB patients. The most common CHDs were patent ductus arteriosus and ventricular septal defect (VSD). Univariate and multivariate regression analyses showed that the type of procedure (surgical method) and the type of CHD (VSD) correlated with postprocedural CHB. Patients who developed postprocedural CHB had a longer mean stay in the pediatric cardiac critical care unit than non-CHB patients. The postoperative in-hospital mortality rate was 5.2%, with no correlation between CHB occurrence and in-hospital mortality.

Conclusion: The findings highlight the importance of attentive monitoring for postprocedural CHB, particularly in younger patients, to facilitate timely intervention and improve outcomes. Further research is warranted to explore the long-term complications and risk factors associated with postprocedural CHB in this patient population.