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Arrhythmia surgery in patients with and without congenital heart disease

Constantine Mavroudis1, Barbara J Deal, Carl L Backer

  • 1Division of Cardiovascular-Thoracic Surgery, Children's Memorial Hospital, Chicago, Illinois 60614, USA. cmavroudis@childrensmemorial.org

The Annals of Thoracic Surgery
|August 30, 2008
PubMed

Insights

Surgical treatment for atrial arrhythmias in patients with and without congenital heart disease offers a high success rate and low recurrence. Ventricular arrhythmia surgery is less predictable, with outcomes influenced by heart condition complexity.

Area of Science:

  • Cardiac Surgery
  • Electrophysiology
  • Congenital Heart Disease

Background:

  • Arrhythmia surgery significantly improves outcomes for debilitating atrial and ventricular arrhythmias.
  • This study focuses on patients undergoing arrhythmia operations, with or without congenital heart repairs, excluding Fontan conversion cases.

Purpose of the Study:

  • To review arrhythmia mechanisms and document long-term outcomes of arrhythmia surgery.
  • To evaluate the efficacy of surgical interventions for various arrhythmias in diverse patient groups.

Main Methods:

  • A retrospective analysis of 100 patients (1987-2007) undergoing arrhythmia operations.
  • Patients were categorized based on the presence of associated congenital heart disease and ventricular function.
  • Arrhythmia types included macro-reentrant atrial tachycardia, atrial fibrillation, accessory connections, AVNRT, focal atrial tachycardia, and ventricular tachycardia.

Main Results:

  • Operative mortality was 3.0%, primarily due to advanced congenital heart disease.
  • Long-term freedom from arrhythmia recurrence was 94% at 1 year and 85% at 10 years for atrial arrhythmias.
  • For ventricular arrhythmias, 1-year and 10-year freedom from recurrence was 85% and 68%, respectively.

Conclusions:

  • Surgical ablation for atrial arrhythmias is safe and effective, with high recurrence-free rates in patients with and without congenital heart disease.
  • Surgical treatment for ventricular arrhythmias shows less predictable outcomes.
  • Underlying congenital heart disease complexity and hemodynamic status are key factors influencing arrhythmia recurrence or new onset.
Abstract

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