Treatment is therefore aimed at rate reduction and restoration of AV synchrony by pacing. JET behaves like an automatic tachycardia so typically does not cardiovert in response to DC shock, adenosine or overdrive pacing. This can rapidly result in a life threatening low cardiac output state (LCOS), especially if the patient was previously haemodynamically compromised. The global cardiac output may be reduced as a result of the impaired ventricular filling that arises due to the loss of the atrial systolic contribution and the shortened time for diastolic filling consequent upon the tachycardia. It is an incessant tachycardia, often with AV dyssynchrony, that results in the detrimental combination of an increased myocardial workload and oxygen consumption in the presence of a reduced myocardial oxygen supply. JET is a self-limiting tachyarrhythmia, typically occurring within 72 hours of cardiac surgery and resolving within 8 days. It has been documented after all types of cardiac surgery, including extracardiac procedures such as Extra cardiac Fontan and Blalock Taussig shunt. It is thought to be caused by trauma or oedema around the bundle of His, but is not necessarily related to surgery near the His bundle. It has a higher incidence in infants < 6 months. Junctional ectopic tachycardia (JET) (also known as usual complex VT or His bundle tachycardia) is the most common troublesomepostoperative tachyarrhythmia in children, occurring in 5-10% of post-operative cardiac patients, and can be a cause of significant morbidity and mortality in the PICU.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |