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The mysterious enemy after heart surgery: Why do some children experience combined ectopic heart beats?
With the advancement of cardiac surgery, more and more children are able to recover successfully, but there is a condition that cannot be ignored and makes parents anxious, that is, Junctional Ectopic Tachycardia (JET) . This rare heart syndrome usually occurs after heart surgery and is most noticeable within 24 to 48 hours after surgery. The appearance of JET not only affects the child's recovery process, but may even cause complications, becoming a mysterious enemy in postoperative recovery.
Pathophysiology of JET
Normally, the electrical activity of the heart begins in the sinoatrial node (SA node), then propagates to the atrioventricular node (AV node), and reaches the ventricles through the His bundle. However, JET patients have abnormalities in the conduction pathway of electrical signals, causing their hearts to beat faster than normal.
The cause of JET is often related to manipulation of surrounding AV node tissue during surgery, but this theory remains controversial.
During surgery, the heart's tissue may be manipulated, leading to abnormal electrical activity associated with the AV node. This is more pronounced in some pediatric patients and not just based on the effects of surgery.
How to diagnose JET?
The diagnosis of JET mainly relies on the 12-lead electrocardiogram (ECG). Typical symptoms include an increased heart rate, usually between 170 and 260 beats per minute. The QRS complex is usually narrow but may be wider if bundle branch block is present.
In JET, the AV node may be unable to conduct electrical signals from the ventricles to the atria, resulting in discordant activity between the atria and ventricles.
By administering adenosine, doctors can differentiate JET from other forms of atrial or ventricular tachycardia, such as atrioventricular nodal reentrant tachycardia (AVNRT). Such analysis can help determine the most appropriate treatment plan.
JET treatment method
Treatment focuses on lowering the heart rate and includes correction of acidosis, adjustment of electrolyte levels, and use of antiarrhythmic drugs.
For patients with JET, medications such as propranolol and verapamil are common options.
Taking into account possible side effects, doctors usually choose the most appropriate medication regimen based on the condition. For frequent JET symptoms, catheter ablation may be a viable alternative treatment, although this procedure still carries the risk of complications.
Epidemiology of combined ectopic beats
JET most commonly occurs in children hospitalized for cardiac surgery, with the proportions affected varying by type of surgery. According to statistics, the chance of JET occurring after Tetralogy of Fallot surgery is relatively high.
What does this mean?
When parents face their children experiencing JET after surgery, it is undoubtedly a daunting challenge. Understanding how this condition works and how to treat it can not only help parents reduce their anxiety, but also allow doctors and patients to jointly address this epidemiological phenomenon.
Faced with JET, are parents ready for this battle against heart health?
