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Late atrial tachyarrhythmias in adult Fontan patients
Session:
Posters (Sessão 1 - Écran 4) - Cardiopatias congénitas
Speaker:
Mariana Carvalho
Congress:
CPC 2023
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
20. Congenital Heart Disease and Pediatric Cardiology
Subtheme:
20.6 Congenital Heart Disease – Clinical
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Mariana Ferreira Carvalho; Izidro Borges; João Dias; Diogo Faim; Patrícia Vaz Silva; Dina Rodrigues; António Pires
Abstract
<p>Introduction: Fontan surgery is a palliative surgical procedure used in children with univentricular hearts. One of the late complications is the development of atrial tachyarrhythmias affecting usually in adulthood and its risk factors are still poorly defined.</p> <p>Objective: We aim to assess the predictors of the development of atrial tachyarrhythmias (atrial fibrillation and atrial flutter) in adults’ patients previously submitted to Fontan surgery.</p> <p>Methods: Single-center retrospective cohort study of patients ≥18 years of age with Fontan circulation followed at our tertiary care center of adult congenital heart disease outpatient setting. The median follow-up time was 4 (2–9) years. Demographic, clinical and imaging records were collected. Logistic regression analysis was performed to assess independent predictors of atrial arrythmias.</p> <p>Results: 32 patients were included (age 38.9±9.1 years, 61% men). After a mean of 10.2±7.1 years, atrial tachyarrhythmias was noted in 11 patients (34.4%), of which 4 developed had atrial fibrillation (12.5%). Variables identified as significant independent predictors for the development of atrial arrhythmia were older age at the time of initial repair (OR: 3.0, CI:1.7-4.6, p<0001), number of prior cardiac surgeries (OR: 2.2, 95% CI: 1.89-4.5, p=0.025), and prior atriopulmonary Fontan surgery (OR: 6.12, 95% CI: 2.3-15.2, p=0.003).</p> <p>Conclusions: Older age at surgery, atriopulmonary connection and number of prior surgeries are significant independent risk factors for the presence of late atrial tachyarrhythmias in adult survivors of Fontan procedure.</p>
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