Most Common Forms of Arrhythmia in Congenital Heart Disease

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The predominant arrhythmia pattern was paroxysmal, persistent, and permanent in 62.3%, 28.2%, and 9.5%.
The predominant arrhythmia pattern was paroxysmal, persistent, and permanent in 62.3%, 28.2%, and 9.5%.

HealthDay News — For patients with congenital heart disease and atrial arrhythmias, the most common presenting arrhythmia is intra-atrial re-entrant tachycardia (IART), according to a study published in the Journal of the American College of Cardiology.

Fabien Labombarda, MD, from the Montreal Heart Institute, and colleagues conducted a multicenter cohort study involving 482 patients with congenital heart disease and atrial arrhythmias.

The researchers found that IART was the most common presenting arrhythmia (61.6%), followed by atrial fibrillation and focal atrial tachycardia (28.8% and 9.5%, respectively). There was an increase in the proportion of arrhythmias due to IART with increasing congenital heart disease complexity (47.2%, 62.1%, and 67.0%, respectively, for simple, moderate, and complex defects). 

Among those aged ≥50 years, atrial fibrillation increased with age to surpass IART as the most common arrhythmia (51.2% vs 44.2%). Independent associations with atrial fibrillation were seen for older age (odds ratio, 1.024 per year) and hypertension (odds ratio, 2.00). The predominant arrhythmia pattern was paroxysmal, persistent, and permanent in 62.3%, 28.2%, and 9.5% during a mean follow-up of 11.3 ± 9.4 years. There was an increase in permanent atrial arrhythmias from 3.1% to 22.6% in patients aged <20 years to ≥50 years.

"Atrial fibrillation increases in prevalence and atrial arrhythmias progressively become permanent as the population ages," the authors write.

The study was funded by a grant from Boehringer Ingelheim.

Reference

Labombarda F, Hamilton R, Shohoudi A, et al. Increasing prevalence of atrial fibrillation and permanent atrial arrhythmias in congenital heart disease. J Am Coll Cardiol. 2017 Aug 15;70(7):857-865.


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