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Concomitant arrhythmia surgery in patients with congenital heart disease

Tanwier T T K Ramdjan1, Elisabeth M J P Mouws1,2, Charles Kik2

  • 1Department of Cardiology, Erasmus University Medical Center, Rotterdam, Netherlands.

Interactive Cardiovascular and Thoracic Surgery
|June 14, 2018
PubMed

Insights

Arrhythmia surgery in congenital heart disease (CHD) patients offers limited success, with a majority experiencing atrial fibrillation (AF) recurrence. Persistent AF and older age at surgery predict higher recurrence rates.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Congenital Heart Disease

Background:

  • Atrial tachyarrhythmias like atrial fibrillation (AF) are common in congenital heart disease (CHD) patients.
  • These patients often require multiple surgeries, but data on concomitant arrhythmia surgery effectiveness is limited.

Purpose of the Study:

  • To examine the outcomes of concomitant arrhythmia surgery for AF, atrial flutter (AFL), and intra-atrial reentrant tachycardia (IART) in patients with CHD.

Main Methods:

  • A cohort of 66 CHD patients undergoing concomitant arrhythmia surgery was analyzed.
  • Follow-up data was collected to assess recurrence of AF, AFL, and IART.

Main Results:

  • AF recurred in 67% of patients; late recurrence-free survival varied by AF type (71% for paroxysmal, 45% for persistent, 20% for long-standing persistent).
  • Older age at surgery was an independent predictor of late AF recurrence.
  • New-onset AFL/IART occurred in 17% of patients.

Conclusions:

  • Concomitant arrhythmia surgery provides freedom from late AF recurrence for a minority of CHD patients.
  • (Long-standing) persistent AF and older age at surgery are associated with increased recurrence rates.
Abstract

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