Detection of cardiac dysrhythmias by continuous electrocardiographic recording in children undergoing cardiac surgery

The incidence of dysrhythmias was studied using 24-hour ambulatory electrocardiographic monitoring in 65 consecutive cases of children undergoing cardiac surgery. Recordings were made prior to surgery and in the early (1-10 days) and late (3-12 months) post operative periods. Prior to surgery, 25% of the patients displayed supraventricular dysrhythmias (SVD) and 39% ventricular dysrhythmias (VD). Immediately following surgery a dramatic increase in incidence occurred in both SVD and VD. On late follow-up the frequency of ectopy decreased but not to pre-operative levels. Standard 12-lead ECG was much less sensitive than Holter monitoring, detecting less than 25% of all dysrhythmias. Assessment of preoperative rhythm status is necessary to properly interpret postoperative dysrhythmias. Twenty-four hour ambulatory ECG recording is essential for the detection and evaluation of dysrhythmias in children undergoing cardiac surgery.