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Arrhythmias in congenitally corrected transposition of the great arteries: an international study

Jean-Marc Sellal1, Nabil Dib2, Matilde Karakachoff3

  • 1Department of Cardiology, CHRU-Nancy, Université de Lorraine, Nancy, France.

European Heart Journal
|July 18, 2025
PubMed

Insights

The arrhythmia burden in patients with congenitally corrected transposition of the great arteries (ccTGA) is significant. This study found high rates of atrial arrhythmia, ventricular arrhythmia, and complete atrioventricular block, with surgery increasing risk.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Electrophysiology

Background:

  • Limited data exists on arrhythmia burden in patients with congenitally corrected transposition of the great arteries (ccTGA).
  • Understanding arrhythmia incidence is crucial for managing this complex congenital heart defect.

Purpose of the Study:

  • To quantify the incidence of atrial arrhythmia (AA), ventricular arrhythmia (VA), and complete atrioventricular block (CAVB) in ccTGA patients.
  • To identify factors associated with these arrhythmias in the ccTGA population.

Main Methods:

  • International, multi-center, retrospective cohort study (1990-2018) involving 1131 ccTGA patients.
  • Analysis of combined and individual arrhythmia outcomes (AA, VA, CAVB).
  • Uni-variable and multi-variable Cox regression to assess associated factors.

Main Results:

  • High cumulative incidence of arrhythmias, reaching 58.8% by 20 years.
  • Surgery/intervention significantly increased the risk of AA (HR 3.01), VA (HR 1.73), and CAVB (HR 3.65).
  • Left bundle branch block associated with higher VA risk (HR 4.03); right bundle branch block with higher CAVB risk (HR 3.71).

Conclusions:

  • Patients with ccTGA experience a substantial arrhythmia burden.
  • The incidence of AA, VA, and CAVB is high, underscoring the need for vigilant monitoring and management strategies.
Abstract

Keywords:
Atrial arrhythmiaComplete atrioventricular blockDouble discordanceVentricular arrhythmia

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