Related Experiment Video
Updated: Jun 4, 2026
06:29
Wireless Telemetry Device Implantation in a Fontan Ovine Model for Continuous and Long-Term Hemodynamic Monitoring
Published on: May 2, 2025
Impact of Fontan conversion with arrhythmia surgery and pacemaker therapy
Takeshi Hiramatsu1, Yusuke Iwata, Goki Matsumura
1Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan. shiramat@hij.twmu.ac.jp
Summary
Fontan conversion with arrhythmia surgery and pacemaker implantation improved heart rhythm in 80% of survivors. This intervention enhanced quality of life and New York Heart Association status in patients long after their initial Fontan operation.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Atrial arrhythmia significantly impacts long-term quality of life after Fontan operation.
- Restoring regular heart rhythm is crucial for improving patient outcomes post-Fontan.
Purpose of the Study:
- To evaluate the impact of Fontan conversion combined with arrhythmia surgery and pacemaker therapy.
- To assess the mid-term clinical outcomes and quality of life improvements.
Main Methods:
- 38 patients underwent Fontan conversion with extracardiac conduit.
- 22 patients had simultaneous maze procedure (cryoablation/radiofrequency ablation) and DDD pacemaker implantation for atrial arrhythmia.
- 16 patients maintained sinus rhythm; mean follow-up was 52 months.
Main Results:
- Actual survival rates at 1 and 5 years were 80% and 64%, respectively (excluding early deaths).
- 80% of survivors achieved regular heart rhythm (including pacemaker rhythm), a significant increase from 43% pre-conversion.
- Postoperative New York Heart Association (NYHA) class improved, with 74% in NYHA I and 26% in NYHA II.
Conclusions:
- Fontan conversion with arrhythmia surgery and pacemaker therapy yields acceptable mid-term results.
- Restoration of regular cardiac rhythm positively influences postoperative NYHA status and daily activity levels.
Related Concept Videos
01:29Cardiomyopathy V: Interprofessional Care
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
01:25Dysrhythmias VI: Management of Dysrhythmias
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
01:25Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...