Heart block in children following heart surgery increases length of hospital stay and total costs
Following surgery to repair congenital heart defects, children can develop postoperative complete heart block. That’s when signals for the heart to beat are completely blocked. Analyzing information from a large national database, researchers discovered little change over time in the frequency of heart block following surgery on these children. They also found that the development of heart block increases the children’s length of hospital stay and total costs. Over a 10-year period, researchers collected data from the Kids’ Inpatient Databases (KID) at four time points: 2000, 2003, 2006, and 2009. KID was developed by the Agency for Healthcare Research and Quality (AHRQ) to analyze inpatient visits by children up to age 20. For this study, children 24 months of age or younger were identified who had surgical repair of three different types of congenital heart defects. From this group, the researchers determined those children who experienced a postoperative complete heart block and those who required the placement of a pacemaker.
During the 10-year period, 16,105 children underwent heart surgery. Between 3.7 and 7.7 percent developed heart block. Pacemakers were required for 0.9 and 2.3 percent of these patients before discharge. Although there was a decrease in postoperative mortality, there was no significant change in the number of patients who developed heart block or who required a pacemaker during the 10-year study period. The highest rate of heart block was found in patients undergoing repair for atrioventricular canal defects. Hospital stays were longer and total costs were higher for patients who developed heart block. Age at the time of surgery was not a predictor of developing heart block, although there is a growing trend for these surgeries to be performed at a younger age. The study was supported in part by AHRQ (HS16957).
See "Postoperative heart block in children with common forms of congenital heart disease: Results from the KID database," by Jeffrey B. Anderson, M.D., M.P.H., Richard J. Czosek, M.D., Timothy K. Knilans, M.D., and others in the June 26, 2012 Journal of Cardiovascular Electrophysiology [Epub ahead of print].