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 Dexmedetomidine controls junctional ectopic tachycardia during Tetralogy of Fallot repair in an infant

Michelle LeRiger1, Aymen Naguib1, Mark Gallantowicz2, Joseph D Tobias3
1 Department of Anesthesiology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43105, USA
2 Department of Cardiothoracic Surgery and The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43105, USA
3 Department of Anesthesiology and Pediatrics, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43105, USA

Correspondence Address:
Michelle LeRiger
Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43105
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.97978

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Year : 2012  |  Volume : 15  |  Issue : 3  |  Page : 224-228

 
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Dexmedetomidine is a highly selective α2 -adrenergic agonist approved for short-term sedation and monitored anesthesia care in adults. Although not approved for use in the pediatric population, an increasing number of reports describe its use in pediatric patients during the intraoperative period and in the intensive care unit. Dexmedetomidine can potentially have an adverse impact on the cardiovascular system secondary to its negative chronotropic and dromotropic effects. However, it is these cardiac effects that are currently being explored as a therapeutic option for the treatment of perioperative tachyarrhythmias in pediatric patients with congenital heart disease (CHD). We report the use of dexmedetomidine to treat junctional ectopic tachycardia (JET), which developed following cardiopulmonary bypass for surgical correction of Tetralogy of Fallot in a 6-week-old infant. Within 15 min of increasing the dexmedetomidine infusion from 0.5 to 3 μg/kg/h, JET converted to normal sinus rhythm. This case report provides additional anecdotal evidence that dexmedetomidine may have a therapeutic role in the treatment of perioperative tachyarrhythmias in pediatric patients with CHD. The specific effects of dexmedetomidine on the cardiac conduction system are reviewed followed by a summary of previous reports describing its use as a therapeutic agent to treat perioperative arrhythmias.






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Michelle LeRiger1, Aymen Naguib1, Mark Gallantowicz2, Joseph D Tobias3
1 Department of Anesthesiology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43105, USA
2 Department of Cardiothoracic Surgery and The Heart Center, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43105, USA
3 Department of Anesthesiology and Pediatrics, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43105, USA

Correspondence Address:
Michelle LeRiger
Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43105
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.97978

Rights and Permissions

Dexmedetomidine is a highly selective α2 -adrenergic agonist approved for short-term sedation and monitored anesthesia care in adults. Although not approved for use in the pediatric population, an increasing number of reports describe its use in pediatric patients during the intraoperative period and in the intensive care unit. Dexmedetomidine can potentially have an adverse impact on the cardiovascular system secondary to its negative chronotropic and dromotropic effects. However, it is these cardiac effects that are currently being explored as a therapeutic option for the treatment of perioperative tachyarrhythmias in pediatric patients with congenital heart disease (CHD). We report the use of dexmedetomidine to treat junctional ectopic tachycardia (JET), which developed following cardiopulmonary bypass for surgical correction of Tetralogy of Fallot in a 6-week-old infant. Within 15 min of increasing the dexmedetomidine infusion from 0.5 to 3 μg/kg/h, JET converted to normal sinus rhythm. This case report provides additional anecdotal evidence that dexmedetomidine may have a therapeutic role in the treatment of perioperative tachyarrhythmias in pediatric patients with CHD. The specific effects of dexmedetomidine on the cardiac conduction system are reviewed followed by a summary of previous reports describing its use as a therapeutic agent to treat perioperative arrhythmias.






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  © Annals of Cardiac Anaesthesia | Published by Wolters Kluwer - Medknow
 Online since 5th January, 2008