Effect of preoperative propranolol on postoperative junctional ectopic tachycardia after complete surgical repair of Tetralogy of Fallot: A prospective observational study

Background: Postoperative junctional ectopic tachycardia (JET) is a common and transient phenomenon occurring after repair of Tetalogy of Fallot (TOF). Although propranolol is used in these patients to prevent and control hypercyanotic spells, its effects are not widely studied in postoperative scenario. Aims: The aim of this study was to examine the effect of preoperative use of propranolol on the incidence of postoperative JET after complete surgical correction of TOF. Materials and Methods: This is a prospective observational study of 51 patients undergoing complete repair of TOF between July 2010 and February 2012. Of these, 25 patients did not receive propranolol (control group) and 26 patients did receive it (propranolol group). Results: Lowest hematocrit on Cardiopulmonary Bypass (CPB) was significantly low in control group compared to propranolol group ( P = 0.008). Though inotropic score was high ( P = 0.015), incidence of postoperative JET was significantly low in propranolol group compared to control group ( P = 0.040). Conclusions: Our findings suggest that the preoperative use of propranolol is associated with a lower incidence of JET after complete surgical repair of TOF. A randomized control trial should be considered to explore causality.