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Updated: Feb 1, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Patterns of Incidence Rates of Cardiac Complications in Patients With Congenital Heart Disease
Ketina Arslani1, Nico Roffler1, Marzena Zurek2
1Department of Cardiology, University Hospital of Basel, University of Basel, Basel, Switzerland.
Insights
Cardiac complications in congenital heart disease are uncommon in childhood but increase significantly in adulthood. Lifelong follow-up is crucial for managing these conditions and allocating resources effectively.
Area of Science:
- Cardiology
- Pediatrics
- Public Health
Background:
- Congenital heart disease (CHD) affects individuals throughout their lives.
- Cardiac complications represent a significant concern for patients with CHD.
Purpose of the Study:
- To evaluate the age of first cardiac complication onset in patients with CHD.
- To analyze the variation in complication frequency across different CHD types.
Main Methods:
- Analysis of data from the Swiss Adult Congenital Heart Disease Registry (SACHER).
- Inclusion of cardiac complications up to the point of registry inclusion.
- Calculation of incidence rates (IR) per 1000 patient-years for various age categories and diagnosis groups.
Main Results:
- 28% of 2731 patients experienced at least one cardiac complication, with 72% occurring in adulthood.
- Incidence rates for most complications were low in childhood (age ≤ 17 years), except for perioperative stroke and complete heart block.
- Incidence of complications, particularly atrial fibrillation and flutter, increased significantly in adults aged ≥ 50 years.
Conclusions:
- Cardiac complications are frequent in CHD, with a notable increase in incidence during adulthood.
- Low childhood complication rates (except for specific conditions) highlight the importance of lifelong monitoring.
- Findings support the need for continuous follow-up and optimized resource allocation for CHD management.
Background:
This study aimed to evaluate age at the first onset of cardiac complications and variation of frequency of complications between different congenital heart defects.
Methods:
The analysis included participants of the Swiss Adult Congenital Heart Disease Registry (SACHER). For this study, cardiac complications up to the time of inclusion in SACHER were analysed. Complications included atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular tachycardia, complete heart block, heart failure, stroke, endocarditis, myocardial infarction, and pulmonary hypertension. Incidence rates (IR; incidence rate per 1000 patient-years) for different age categories and diagnosis groups were analysed.
Results:
Of 2731 patients (55% male, mean age 34 ± 14 years, 92,349 patient-years), a total of 767 (28%) had experienced at least 1 cardiac complication. The majority of complications (550; 72%) occurred in adulthood (> 18 years). Apart from perioperative stroke (IR: 1.77 in age group ≤ 4 years) and complete heart block (IR: 2.36 in age group ≤ 4 years), IR were much lower in childhood (IR < 1 for all complications between 5 and 17 years). Incidence of cardiac complications increased during adult life with highest IR for atrial fibrillation and atrial flutter in the age group ≥ 50 years (IR: 17.6 and 9.7, respectively). There were important variations of the distribution of complications among different diagnosis groups.
Conclusions:
Cardiac complications are frequent in congenital heart disease. Apart from perioperative stroke and complete heart block, IR are low in childhood but the incidence increases during adult life. These data underscore the need of lifelong follow-up and may help for better allocation of resources maintaining follow-up.
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