Abstract：OBJECTIVE: To identify the risk factors for accelerated junctional escape rhythm (AJER) in children early after percutaneous ventricular septal defect (VSD) closure. METHODS: A retrospective controlled study was conducted on 42 children who had AJER within one week after percutaneous VSD closure between January 2008 and October 2012. These subjects were compared with controls without AJER after VSD closure in terms of age, sex, diameter of VSD, occluder size, difference between occluder size and diameter of VSD, and distance between VSD and aortic valve ring. Risk factors for AJER were identified by logistic regression analysis. RESULTS: Compared with the control group, the AJER group had a longer distance betweenVSD and aortic valve ring, a larger diameter of VSD (basal diameter), a larger occluder size (waist diameter) , and a bigger difference between the waist diameter of occluder and diameter of VSD (P<0.05). Logistic regression analysis showed that distance between VSD and aortic valve ring (OR=1.813, P<0.05) and occluder size (OR=1.671, P<0.05) are primary risk factors for AJER. CONCLUSIONS: AJER early after percutaneous VSD closure is related to diameter of VSD, occluder size, difference between the waist diameter of occluder and diameter of VSD, and distance between VSD and aortic valve ring. The distance between VSD and aortic valve ring and occluder size are primary risk factors for AJER.
WEI Li,QIAO Li-Na,LU Yong-Yi et al. Risk factors for accelerated junctional escape rhythm in children early after percutaneous ventricular septal defect closure[J]. CJCP, 2013, 15(10): 831-834.
Nikyar B, Sedehi M, Mirfazeli A, Qorbani M, Golalipour MJ. Prevalence and pattern of congenital heart disease among Neonates in Gorgan, Northern Iran (2007-2008) [J]. Iran J Pediatr, 2011, 21(3): 307-312.
[2]
Van der Linde D, Konings EE, Slager MA, Witsenburg M, Helbing WA, Takkenberg JJ, et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis[J]. J Am Coll Cardiol, 2011, 58(21): 2241-2247
[3]
Pedra CA, Pedra SR, Esteves CA, Pontes SC Jr, Braga SL, Arrieta SR, et al. Percutaneous closure of perimembranous ventricular septal defects with the Amplatzer device:technical and morphological considerations[J]. Catheter Cardiovasc Interv, 2004, 61(3): 403-410.
[4]
Chungsomprasong P, Durongpisitkul K, Vijarnsorn C, Soongswang J, Le TP. The results of transcatheter closure of VSD using Amplatzer device and Nit Occlud Lecoil[J]. Catheter Cardiovasc Interv, 2011, 78(7): 1032-1040.
[5]
Fu YC, Bass J, Amin Z, Radtke W, Cheatham JP, Hellenbrand WE, et al. Transcatheter closure of perimembranous ventricular septal defects using the new Amplatzer membranous VSD occluder: results of the U.S.phase I trial[J]. J Am Coll Cardiol, 2006, 47(2): 319-325.
[6]
Thanopoulos BV, Rigby ML, Karanasios E, Stefanadis C, Blom N, Ottenkamp J, et al. Tran-scatheter closure of perimembranous ventricular septal defects in infants and children using the Amplatzer perimembranous ventricular septal defect occluder[J].Am J Cardiol, 2007, 99(7): 984-989.
[7]
Butera G, Carminati M, Chessa M, Piazza L, Micheletti A, Negura DG, et al. Transcatheter closure of perimembranous ventricular septal defects:early and long-term results[J]. J Am Coll Cardiol, 2007, 50(12): 1189-1195.
[8]
Khairy P, Dore A, Talajic M, Dubuc M, Poirier N, Roy D, et al. Arrhythmias in adult congenital heart disease[J]. Expert Rev Cardiovasc Ther, 2006, 4(1): 83-95.
[9]
Thompson A, Balser JR. Perioperative cardiac arrhythmias[J]. Br J Anaesth, 2004, 93(1): 86-94.
Holzer R, de Giovanni J, Walsh KP, Tometzki A, Goh T, Hakim F, et al. Transcatheter closure of perimembranous ventricular septal defects using the amplatzer membranous VSD occluder:Immediate and midterm results of an international registry[J]. Catheter Cardiovasc Interv, 2006, 68(4): 620-628.
