Abstract
Background: Junctional ectopic tachycardia (JET) is one troublesome supraventricular arrhythmia in postoperative pediatric cardiac surgical patients. Unless treated timely and effectively it may lead to morbidity and even mortality. Aim: To understand the role of Ivabradine in the treatment of JET in postoperative pediatric cardiac surgical patients. Case: We present a postoperative case of complete repair of Tetralogy of Fallot who was in normal sinus rhythm in the preoperative period and developed JET 4 hours later in postoperative period which was persistent despite measures to optimize the internal milieu of the body and conventional antiarrhythmics, that was successfully treated with Ivabradine at a dose of 0.05 mg/kg/12 hourly. Conclusion: Ivabradine can be used to successfully treat postoperative JET in cases ofrefractory to other antiarrhythmic drugs like Digoxin and Amiodarone.
Highlights
Junctional ectopic tachycardia (JET) is the commonest rhythm disturbance following surgery for congenital heart disease [1] and is usually self-limiting [2]
Case: We present a postoperative case of complete repair of Tetralogy of Fallot who was in normal sinus rhythm in the preoperative period and developed JET 4 hours later in postoperative period which was persistent despite measures to optimize the internal milieu of the body and conventional antiarrhythmics, that was successfully treated with Ivabradine at a dose of 0.05 mg/kg/12 hourly
Ivabradine is a new rate-controlling drug used as a selective antagonist of the If current and produces substantial reduction in the rate of spontaneous action potential firing in sinoatrial node cells [5]
Summary
Junctional ectopic tachycardia (JET) is the commonest rhythm disturbance following surgery for congenital heart disease [1] and is usually self-limiting [2]. Control of heart rate or conversion to sinus rhythm is of paramount importance but is often challenging and may require more than one antiarrhythmic drug for its treatment [3] [4]. The successful treatment of our patient with oral ivabradine provides a new therapeutic option, having its action on AV node along with SA node, its uncommon use in postoperative pediatric cardiac surgical patients without any side effects. Junctional ectopic tachycardia (JET) is one troublesome supraventricular arrhythmia in postoperative pediatric cardiac surgical patients. Aim: To understand the role of Ivabradine in the treatment of JET in postoperative pediatric cardiac surgical patients. Conclusion: Ivabradine can be used to successfully treat postoperative JET in cases of refractory to other antiarrhythmic drugs like Digoxin and Amiodarone.
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