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Arrhythmia and exercise intolerance in Fontan patients: current status and future burden

L Idorn1, K Juul, A S Jensen

  • 1Department of Cardiology, Rigshospitalet, Copenhagen, Denmark; Department of Pediatrics and Adolescent Medicine, Section of Pediatric Cardiology, Rigshospitalet, Copenhagen, Denmark.

International Journal of Cardiology
|January 22, 2013
PubMed

Insights

Long-term Fontan procedure survivors face increasing risks of arrhythmias and exercise intolerance with age. Future projections indicate a growing burden of these conditions in the aging Fontan population.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Adult Congenital Heart Disease

Background:

  • Long-term survival after the Fontan procedure is excellent but associated with risks of arrhythmias and exercise intolerance.
  • Understanding the current and future burden of these complications is crucial for patient management.

Purpose of the Study:

  • To analyze the current burden of clinically relevant arrhythmia and severe exercise intolerance in Danish Fontan patients.
  • To estimate the future burden of these conditions based on survival data and age-related trends.

Main Methods:

  • Retrospective analysis of 235 Danish citizens who underwent Fontan completion between 1981 and 2009.
  • Utilized exercise tests, Holter monitoring, echocardiography, pulmonary function tests, and medical record review for surviving patients.
  • Employed survival data and logistic regression models to estimate future prevalence.

Main Results:

  • 11% of patients died or underwent heart transplantation (HTx) post-Fontan.
  • Clinically relevant arrhythmia and severe exercise intolerance increased significantly with age, affecting 32% and 85% of patients ≥ 20 years, respectively.
  • Cardiac index and pulmonary diffusing capacity decreased with age, while ventricular function remained unchanged.

Conclusions:

  • Clinically relevant arrhythmia and severe exercise intolerance significantly increase with age in Danish Fontan patients.
  • The future burden of the Fontan population is projected to rise due to an increasing prevalence of older patients with these complications.
Abstract

Keywords:
ArrhythmiaExercise capacityFontan procedurePrognosis

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