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Related Experiment Videos

Arrhythmias after the Fontan procedure.

N S Peters1, J Somerville

  • 1Department of Cardiac Medicine, National Heart and Lung Institute, London.

British Heart Journal
|August 1, 1992
PubMed
Summary

Arrhythmias after Fontan operations are common and poorly tolerated, especially early on. Late arrhythmias indicate right atrial pressure issues and impaired ventricular function, requiring prompt management of right atrial obstruction and thrombus.

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Area of Science:

  • Cardiology
  • Pediatric Cardiac Surgery
  • Electrophysiology

Background:

  • The Fontan procedure is a palliative surgery for complex congenital heart defects.
  • Arrhythmias are a known complication following Fontan-type operations.

Purpose of the Study:

  • To investigate the factors influencing the development of arrhythmias after Fontan operations.
  • To determine the outcomes associated with these arrhythmias.

Main Methods:

  • Retrospective analysis of 60 patients who underwent Fontan-type procedures between 1972 and 1986.
  • Follow-up ranged from 5 to 19 years (mean 12 years).

Main Results:

  • 57% of patients experienced postoperative arrhythmias, with 58% of early deaths linked to them.
  • Late arrhythmias (37% of survivors) correlated with higher right atrial pressures and reduced ventricular function.
  • Right atrial obstruction and thrombus were frequent in patients with atrial arrhythmias.

Conclusions:

  • Early arrhythmias, particularly atrial fibrillation and His bundle tachycardia, are poorly tolerated and may warrant contraindicating prior atrial fibrillation.
  • Late arrhythmias suggest underlying right atrial obstruction and necessitate its investigation and treatment.
  • Anticoagulant therapy is recommended for right atrial thrombus in patients with arrhythmias.

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