Congenital heart diseaseIdentifying High Risk in Adults With Congenital Heart Disease and Atrial Arrhythmias
Section snippets
Methods
All adult patients with CHD and atrial arrhythmia who were followed serially from January 1999 through December 2009 in the Toronto Congenital Cardiac Centre for Adults were included. We chose these dates to minimize missing data and provide contemporary data. Patients were identified by a search of the institutional database. The study group included all patients with a clinical presentation of documented sustained intra-atrial reentrant tachycardia or atrial fibrillation. Patients who had
Results
In total 378 adult patients with CHD and sustained atrial arrhythmias were included. Baseline characteristics including types of arrhythmias are presented in Table 1. Of all study patients 212 patients (56%) had a history of emergency room visit or hospital admission for sustained atrial arrhythmia. Two hundred fifty-one patients (66%) had paroxysmal atrial arrhythmias; the remainder (n = 127, 34%) had persistent/permanent atrial arrhythmias. Of patients with paroxysmal atrial arrhythmia most
Discussion
The present study provides an estimate of the mortality risk in adult patients with CHD and atrial arrhythmias. In this heterogenous group of adults we found that mortality rates were not uniform. Adults with functional limitation and specific high-risk congenital cardiac lesions (i.e., valvular heart disease, single-ventricle physiology, and pulmonary hypertension) were at increased risk of death. Based on those variables, a risk score was derived to help identify the high-risk adult patient
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2021, HeartRhythm Case ReportsCitation Excerpt :To the best of our knowledge, this is the first report of Watchman device implantation in a complex ACHD patient with single-ventricle physiology. With the growing number of congenital heart disease patients reaching adulthood, numerous long-term complications such as atrial arrhythmias have been observed,5 with associated morbidities including worsening ventricular function and thromboembolic events.6–8 AF is the second most common atrial arrhythmia (29%) in the ACHD population after intra-atrial reentrant tachycardia (68%).2
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2021, International Journal of CardiologyCitation Excerpt :A few studies have presented specific risk models in ACHD patients to predict adverse outcomes [21–23]. Yap et al. identified predictors of mortality in 378 patients with ACHD and atrial arrhythmia to establish a risk score [23]. Kempny et al. reported a multivariable mortality risk stratification model derived from a multicenter cohort study of 1098 adults with Eisenmenger syndrome [21].