Skip to main content
Journal cover image

Arrhythmias Requiring ECMO in Infants Without Structural Congenital Heart Disease.

Publication ,  Journal Article
Well, A; Fenrich, A; Shmorhun, D; Stromberg, D; Lavinghousez, P; Beckerman, Z; Fraser, CD; Mery, CM
Published in: Pediatr Cardiol
April 2022

Arrhythmias account for 55 per 100,000 patient evaluations in pediatric emergency departments. Most arrhythmias in children are amenable to medical management or cardioversion. Rarely, arrhythmias lead to significant hemodynamic instability requiring extracorporeal membrane oxygenation (ECMO) support. This study seeks to evaluate children under 1 year of age with a structurally normal heart requiring ECMO for an arrhythmia. This is a retrospective review of the Extracorporeal Life Support Organization Registry. All patients less than 1 year of age between 2009 and 2019 with a diagnosis of arrhythmia and without a diagnosis of structural heart malformation were included. Demographics, clinical characteristics, and outcomes were assessed with descriptive statistics and univariate and multivariable analyses. A total of 140 eligible patients were identified from the dataset. The most common arrhythmia was supraventricular tachycardia (SVT) in 70 (50%) patients. ECMO complications occurred in 106 (76.3%) patients and survival to discharge was achieved in 120 (85.7%) patients. In-hospital mortality was associated with neuromuscular blockade prior to ECMO [aOR 10.0 (95% CI 2.95-41.56), p < 0.001], neurologic ECMO complication [aOR 28.1 (95% CI 6.6-155.1), p < 0.001], and race with white race being protective [aOR 0.13, (95% CI 0.02-0.21), p = 0.002]. Similar survival and complication rates were found in subgroup analysis of SVT arrhythmias alone. Arrhythmias necessitating ECMO support in infants without structural congenital heart disease is a rare occurrence. However, survival to hospital discharge is favorable at greater than 85%. Given the favorable survival, earlier and more aggressive utilization of ECMO may result in improved outcomes.

Duke Scholars

Published In

Pediatr Cardiol

DOI

EISSN

1432-1971

Publication Date

April 2022

Volume

43

Issue

4

Start / End Page

914 / 921

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Infant
  • Humans
  • Hospital Mortality
  • Heart Defects, Congenital
  • Extracorporeal Membrane Oxygenation
  • Child
  • Cardiovascular System & Hematology
  • Arrhythmias, Cardiac
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Well, A., Fenrich, A., Shmorhun, D., Stromberg, D., Lavinghousez, P., Beckerman, Z., … Mery, C. M. (2022). Arrhythmias Requiring ECMO in Infants Without Structural Congenital Heart Disease. Pediatr Cardiol, 43(4), 914–921. https://doi.org/10.1007/s00246-021-02803-x
Well, Andrew, Arnold Fenrich, Daniel Shmorhun, Daniel Stromberg, Preston Lavinghousez, Ziv Beckerman, Charles D. Fraser, and Carlos M. Mery. “Arrhythmias Requiring ECMO in Infants Without Structural Congenital Heart Disease.Pediatr Cardiol 43, no. 4 (April 2022): 914–21. https://doi.org/10.1007/s00246-021-02803-x.
Well A, Fenrich A, Shmorhun D, Stromberg D, Lavinghousez P, Beckerman Z, et al. Arrhythmias Requiring ECMO in Infants Without Structural Congenital Heart Disease. Pediatr Cardiol. 2022 Apr;43(4):914–21.
Well, Andrew, et al. “Arrhythmias Requiring ECMO in Infants Without Structural Congenital Heart Disease.Pediatr Cardiol, vol. 43, no. 4, Apr. 2022, pp. 914–21. Pubmed, doi:10.1007/s00246-021-02803-x.
Well A, Fenrich A, Shmorhun D, Stromberg D, Lavinghousez P, Beckerman Z, Fraser CD, Mery CM. Arrhythmias Requiring ECMO in Infants Without Structural Congenital Heart Disease. Pediatr Cardiol. 2022 Apr;43(4):914–921.
Journal cover image

Published In

Pediatr Cardiol

DOI

EISSN

1432-1971

Publication Date

April 2022

Volume

43

Issue

4

Start / End Page

914 / 921

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Retrospective Studies
  • Infant
  • Humans
  • Hospital Mortality
  • Heart Defects, Congenital
  • Extracorporeal Membrane Oxygenation
  • Child
  • Cardiovascular System & Hematology
  • Arrhythmias, Cardiac