Robert G. Webster, MD, MPH
The goal of this study is to determine whether temporarily increasing a child's heart rate after heart surgery can improve blood flow and oxygen supply to the body's tissues. The study will compare temporary atrial pacing at 10 and 20 beats per minute above the child's natural heart rate with the child's natural heart rate without pacing. Participants will be randomly assigned to one of two schedules for these pacing approaches. Each pacing approach has previously been used as part of routine care after heart surgery. The study will test whether temporarily increasing the heart rate improves blood flow and oxygen supply during the first 10 hours after surgery.
This study uses a randomized, within-subject design to evaluate three postoperative heart rate conditions: intrinsic sinus rhythm, temporary atrial pacing at 10 beats per minute above the intrinsic sinus rate, and temporary atrial pacing at 20 beats per minute above the intrinsic sinus rate. Participants will be randomized to one of two sequences determining the order in which these conditions are administered. Each pacing condition will be maintained for approximately three hours during the early postoperative period. Participants will be grouped according to single-ventricle or two-ventricl…
Inclusion Criteria: * Age less than 12 years (all potential recruitment). Target recruitment will focus on children less than 12 months at enrollment. Children aged 13-36 months will be eligible for recruitment if we do not meet the target recruitment goals for infants according to the study timeline, and then all patients \< 12 years if recruitment is still below targets. * Scheduled for congenital cardiac surgery at Lurie Children's Hospital * Planned postoperative admission to the CICU * Informed consent obtained from parent(s) or legally authorized representative(s) Exclusion Criteria:…
Temporary atrial pacing is delivered using temporary epicardial atrial pacing wires placed during cardiac surgery. During the protocol-directed pacing period, participants receive atrial pacing at either 10 or 20 beats per minute above their intrinsic sinus heart rate, according to their randomly assigned sequence. Each pacing condition is maintained for approximately three hours. The comparison condition is intrinsic sinus rhythm without protocol-directed atrial pacing. The protocol-directed pacing period occurs during approximately the first 10 postoperative hours. Pacing may be temporarily interrupted, skipped, or discontinued at the discretion of the treating clinical team when clinically indicated.
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