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Carga de la fibrilación auricular en pacientes jóvenes con enfermedad cardíaca congénita
Zacharias Mandalenakis1, Annika Rosengren2, Georg Lappas2
1Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Sweden. zacharias.mandalenakis@gu.se.
Circulation
|November 3, 2017
Resumen
Los pacientes con enfermedad cardíaca congénita (CHD) tienen un riesgo significativamente mayor de desarrollar fibrilación auricular (AF). Este aumento del riesgo, especialmente para los defectos complejos, requiere un monitoreo específico para la FA y sus complicaciones, como la insuficiencia cardíaca.
Área de la Ciencia:
- Cardiología
- Cardiología Pediátrica
- Electrofisiología
Sus antecedentes:
- Se presume que los pacientes con cardiopatía congénita (CHD) tienen un mayor riesgo de fibrilación auricular (AF) debido a factores anatómicos y quirúrgicos.
- Los estudios anteriores no han comparado adecuadamente el desarrollo y las complicaciones de la FA en las poblaciones pediátricas y de adultos jóvenes con respecto a los controles.
Objetivo del estudio:
- Investigar y comparar la incidencia de la fibrilación auricular (FA) en niños y adultos jóvenes con enfermedad cardíaca congénita (CHD) con una población de control.
- Para identificar las complicaciones asociadas con la FA en pacientes con ECH.
Principales métodos:
- Utilizó registros suecos de pacientes y causas de muerte para pacientes con ECC nacidos entre 1970 y 1993.
- Comparamos a cada paciente con 10 controles por año de nacimiento, sexo y condado.
- Seguimiento de la recopilación de datos hasta 2011.
Principales resultados:
- Los pacientes con enfermedad coronaria tenían un riesgo 22 veces mayor de desarrollar FA en comparación con los controles (21,99 veces mayor).
- Los defectos del cono troncal presentaron el mayor riesgo de FA (HR 84.27).
- A la edad de 42 años, el 8,3% de los pacientes con enfermedad coronaria tenían FA; la insuficiencia cardíaca fue una complicación importante (10,7% de los pacientes con enfermedad coronaria con FA).
Conclusiones:
- Los niños y adultos jóvenes con CHD tienen un riesgo sustancialmente elevado de FA.
- Los defectos cardíacos congénitos complejos están asociados con el mayor riesgo de FA, lo que justifica una vigilancia específica.
- La insuficiencia cardíaca es una complicación significativa para los pacientes con enfermedad coronaria que desarrollan FA.
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