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Atrial arrhythmias in adults with congenital heart disease

Judith Bouchardy1, Judith Therrien, Louise Pilote

  • 1McGill Adult Unit for Congenital Heart Disease Excellence, McGill University Health Center and the Jewish General Hospital, Montreal, Quebec, Canada.

Circulation
|October 14, 2009
PubMed

Insights

Atrial arrhythmias are common in adults with congenital heart disease, increasing with age. These arrhythmias significantly raise the risk of adverse events, mortality, and morbidity in this growing patient population.

Area of Science:

  • Cardiology
  • Adult Congenital Heart Disease
  • Electrophysiology

Background:

  • Atrial arrhythmias pose a significant health burden in the general adult population.
  • Adults with congenital heart disease (ACHD) represent a growing demographic with increasing cardiovascular disease.
  • This study investigates the prevalence and impact of atrial arrhythmias in ACHD patients.

Purpose of the Study:

  • To determine the prevalence and lifetime risk of atrial arrhythmias in adults with congenital heart disease.
  • To assess the association between atrial arrhythmias and health outcomes, including mortality and morbidity, in ACHD patients.
  • To project the future burden of atrial arrhythmias in the ACHD population.

Main Methods:

  • A population-based analysis was conducted using data from 1983 to 2005.
  • Prevalence, lifetime risk, mortality, and morbidity associated with atrial arrhythmias were analyzed in adults with congenital heart disease.
  • Statistical analysis included hazard ratios to compare adverse events in patients with and without atrial arrhythmias.

Main Results:

  • In 2005, 15% of 38,428 adults with congenital heart disease had atrial arrhythmias.
  • The 20-year risk of developing atrial arrhythmias increased from 7% at age 20 to 38% at age 50.
  • Atrial arrhythmias were linked to a 2.5-fold increased risk of adverse events, a 47% increase in mortality, doubled risk of morbidity (stroke/heart failure), and tripled risk of cardiac interventions.

Conclusions:

  • Atrial arrhythmias affect 15% of adults with congenital heart disease and increase with age.
  • These arrhythmias are associated with a doubled risk of adverse events in ACHD patients.
  • Anticipated increases in healthcare resource allocation are necessary to manage this growing burden.
Abstract

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