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Prevalence of Arrhythmia in Adults after Fontan Operation

Magdalena Okólska1, Grzegorz Karkowski2, Marcin Kuniewicz2,3

  • 1Cardiological Outpatient Clinic, Department of Cardiovascular Diseases, John Paul II Hospital, 31-202 Krakow, Poland.

Journal of Clinical Medicine
|April 12, 2022
PubMed

Insights

Arrhythmias are common in adults after the Fontan operation (FO), affecting nearly all patients. Early diagnosis and treatment are crucial for managing these cardiac conditions and preventing serious complications.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Electrophysiology

Background:

  • The Fontan operation (FO) is a palliative surgical procedure for complex congenital heart disease.
  • Cardiac structural, hemodynamic, and morphological changes post-FO can lead to arrhythmias and conduction disorders.
  • Limited research exists on arrhythmias in adult Fontan survivors.

Purpose of the Study:

  • To determine the types and prevalence of arrhythmias and conduction disorders in adult patients following the Fontan operation.
  • To assess the long-term cardiac health of Fontan survivors under medical surveillance.

Main Methods:

  • Retrospective analysis of 50 adult patients who underwent the Fontan operation.
  • Data collection included physical examination, echocardiography, and 24-hour electrocardiogram (ECG) monitoring.
  • Median follow-up duration was 4 years.

Main Results:

  • Bradyarrhythmia was diagnosed in 44% of patients, supraventricular tachyarrhythmias in 28%, and ventricular arrhythmias (VAs) in 12%.
  • Six patients (12%) required pacemaker implantation, and three (6%) underwent radiofrequency catheter ablation.
  • Arrhythmias represent a significant clinical challenge in the adult Fontan population.

Conclusions:

  • Arrhythmias are a widespread issue in adults after the Fontan operation.
  • These arrhythmias can cause significant hemodynamic impairment, necessitating prompt diagnosis and treatment.
  • Modern electrotherapy approaches are vital for managing arrhythmias in Fontan survivors.

Keywords:
Fontan operationcardiac arrhythmiascatheter ablationsingle ventricle

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