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Related Experiment Videos

Dysrhythmias after the modified Fontan procedure.

S C Chen1, S Nouri, D G Pennington

  • 1Departments of Pediatrics and Surgery, St. Louis University School of Medicine, Missouri.

Pediatric Cardiology
|January 1, 1988
PubMed
Summary

Cardiac dysrhythmias are common after the modified Fontan procedure, affecting most patients. However, these arrhythmias were generally well-tolerated, with no sudden deaths or syncope reported in this study of cardiac rhythm management.

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Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Cardiac Surgery

Background:

  • The modified Fontan procedure is a complex surgical intervention for single-ventricle congenital heart defects.
  • Cardiac rhythm disturbances are a known concern following Fontan procedures.
  • Long-term cardiac rhythm outcomes after modified Fontan palliation require further investigation.

Purpose of the Study:

  • To evaluate the incidence and characteristics of cardiac dysrhythmias before and after the modified Fontan procedure.
  • To assess the clinical significance and management of arrhythmias in this patient population.
  • To identify potential risk factors for dysrhythmia development post-procedure.

Main Methods:

  • Retrospective review of cardiac rhythm in 24 patients undergoing modified Fontan procedure.

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  • Analysis of pre- and post-operative cardiac rhythm, including ambulatory monitoring.
  • Assessment of dysrhythmia management, including antiarrhythmic medication and pacing requirements.

    • Main Results:

    • Transient atrial dysrhythmias were common postoperatively.
    • Late supraventricular tachycardia (34.8%) and ventricular dysrhythmias (34.8%) were frequently detected.
    • Most dysrhythmias were asymptomatic or well-tolerated; no sudden deaths or syncope occurred.
    • Seven patients required antiarrhythmic medication; permanent pacing was not needed.

    Conclusions:

    • Cardiac dysrhythmias are prevalent after the modified Fontan procedure.
    • Despite high incidence, arrhythmias are generally well-tolerated in the long term.
    • Close cardiac rhythm monitoring and management are essential for patients post-Fontan palliation.