Related Experiment Video

Updated: Jun 30, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Risk factors of atrial fibrillation progression in patients with congenital heart disease

Can Zhang1, Nawin L Ramdat Misier1, Lixia Dai1

  • 1Department of Cardiology, Unit Translational Electrophysiology, Erasmus Medical Center, Dr. Molewaterplein 40, Rotterdam, 3015GD, Netherlands.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|June 29, 2026
PubMed

Insights

Atrial fibrillation (AF) progression is common in adults with congenital heart disease (CHD). Female sex, mild/moderate CHD complexity, and ventricular pacing are key risk factors for AF progression.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Congenital Heart Disease

Background:

  • Atrial fibrillation (AF) is increasingly prevalent in adults with congenital heart disease (CHD).
  • Predictors of AF progression in this population are poorly defined.
  • Understanding these predictors is crucial for managing cardiovascular health in adults with CHD.

Purpose of the Study:

  • To identify risk factors for the progression of atrial fibrillation (AF) in adults with congenital heart disease (CHD).
  • To elucidate predictors of AF progression in a population where AF is common but risk factors are not well-established.

Main Methods:

  • A cohort of 125 adults with CHD and AF was followed for 17±8 years.
  • AF progression was defined as the transition from paroxysmal to persistent/permanent AF.
  • Time-dependent Cox regression and Fine-Gray competing risk models were used to identify risk factors, evaluating atrial tachycardia, pacing modes, QRS duration, and QTc interval changes.

Main Results:

  • AF progression occurred in 45.6% of patients, with median follow-up of 5 years.
  • Progression was associated with more pronounced QRS duration and QTc interval prolongation.
  • Independent risk factors identified included female sex, mild/moderate CHD complexity, and baseline ventricular pacing.

Conclusions:

  • AF progression is common in adults with CHD and linked to significant ventricular electrical remodeling.
  • Both modifiable (pacing mode) and intrinsic (sex, CHD complexity) factors contribute to AF progression.
  • These findings aid in identifying high-risk CHD patients for targeted monitoring and treatment strategies.
Abstract

Keywords:
Atrial fibrillationAtrial tachyarrhythmiaCongenital heart diseasePacing modeProgression

More Related Videos

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

Related Concept Videos

Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
Mechanism of Cardiac Arrhythmias01:28

Mechanism of Cardiac Arrhythmias

Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...