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Predictors of supraventricular arrhythmias in adults with Ebstein anomaly
Session:
Sessão de Posters 49 - Cardiopatias Congénitas
Speaker:
Julien Lopes
Congress:
CPC 2024
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:
Cartazes
FP Number:
---
Authors:
Julien Lopes; Ana Rita Teixeira; Madalena Coutinho Cruz; Guilherme Portugal; Tânia Branco Mano; Tiago Rito; Mário Martins Oliveira; Rui Cruz Ferreira; Lídia de Sousa
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> Ebstein anomaly (EA) is a congenital heart disease characterized by the apical displacement of tricuspid valve leaflets. Arrhythmias are highly prevalent in this population, posing a clinical challenge. The aim of this study is to characterize supraventricular arrhythmias in an EA population and assess its predictors. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods: </strong>Single-center retrospective study of all consecutive patients with EA referred to a tertiary center for adult congenital heart disease outpatient care. Demographic, clinical, electrocardiographic and imaging data were collected. Supraventricular arrhythmias (atrial fibrillation, atrial flutter and supraventricular tachycardia) arising during follow-up were noted. Predictors of supraventricular arrhythmias were assessed with logistic regression analysis.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results</strong>: A total of 57 patients were included (mean age 49 ± 16.48 years; 54.4% female) with a median follow-up of 11 (IQR 21.63) years. Surgical intervention was required for 21 patients (36.8%) (12 tricuspid valve repair, 5 tricuspid valve replacement, 3 heart transplant). The mean tricuspid valve apical displacement was 30.14 ±12.3mm, with 89.8% of patients presenting with tricuspid regurgitation. 56.1% of patients had evidence of complete right bundle branch block, 15.8% had incomplete right bundle branch block. 13 patients had a documented preexcitation. Supraventricular tachyarrhythmias were noted in 59.6% of patients (n=34), 19.4% with more than one type of arrhythmia (12 with supraventricular tachycardia, 17 with atrial fibrillation and 10 with atrial flutter). 13 patients required electrophysiological study, with 3 patients submitted to cavotricuspid isthmus ablation (5.2%) and 7 patients submitted to accessory pathway ablation (12.3%). Variables significantly associated with supraventricular arrhythmias were prior cardiac surgery (OR 5.200; p=0.006); presence of an additional heart defect (OR 14.929; p<0.001); 1<sup>st</sup> degree AV block (OR 5.600; p=0.007); QRS duration (OR 1.024 p=0.032); tricuspid annular plane systolic excursion (TAPSE) (OR 0.683; p=0.015) and Tissue Doppler tricuspid s’ (OR 0.390; p=0.025). In the multivariate model there were no statistically significant independent predictors. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion:</strong> Supraventricular arrhythmias were highly prevalent in this population of EA patients. However, no independent predictors for supraventricular arrythmias were identified. This underlines the importance of multimodality testing and monitoring of these patients.</span></span></p>
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