Atrial arrhythmias in adult patients with right- versus left-sided congenital heart disease anomalies.

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State: Public
Version: author
Serval ID
serval:BIB_E5410FEC2B70
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Atrial arrhythmias in adult patients with right- versus left-sided congenital heart disease anomalies.
Journal
American Journal of Cardiology
Author(s)
Bernier M., Marelli A.J., Pilote L., Bouchardy J., Bottega N., Martucci G., Therrien J.
ISSN
1879-1913 (Electronic)
ISSN-L
0002-9149
Publication state
Published
Issued date
2010
Volume
106
Number
4
Pages
547-551
Language
english
Notes
Publication types: Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't Publication Status: ppublish
Abstract
Atrial arrhythmias (AAs) are a common complication in adult patients with congenital heart disease. We sought to compare the lifetime prevalence of AAs in patients with right- versus left-sided congenital cardiac lesions and their effect on the prognosis. A congenital heart disease diagnosis was assigned using the International Disease Classification, Ninth Revision, diagnostic codes in the administrative databases of Quebec, from 1983 to 2005. Patients with AAs were those diagnosed with an International Disease Classification, Ninth Revision, code for atrial fibrillation or intra-atrial reentry tachycardia. To ensure that the diagnosis of AA was new, a washout period of 5 years after entry into the database was used, a period during which the patient could not have received an International Disease Classification, Ninth Revision, code for AA. The cumulative lifetime risk of AA was estimated using the Practical Incidence Estimators method. The hazard ratios (HRs) for mortality, morbidity, and cardiac interventions were compared between those with right- and left-sided lesions after adjustment for age, gender, disease severity, and cardiac risk factors. In a population of 71,467 patients, 7,756 adults developed AAs (isolated right-sided, 2,229; isolated left-sided, 1,725). The lifetime risk of developing AAs was significantly greater in patients with right- sided than in patients with left-sided lesions (61.0% vs 55.4%, p <0.001). The HR for mortality and the development of stroke or heart failure was similar in both groups (HR 0.96, 95% confidence interval [CI] 0.86 to 1.09; HR 0.94, 95% CI 0.80 to 1.09; and HR 1.10, 95% CI 0.98 to 1.23, respectively). However, the rates of cardiac catheterization (HR 0.63, 95% CI 0.55 to 0.72), cardiac surgery (HR 0.40, 95% CI 0.36 to 0.45), and arrhythmia surgery (HR 0.77, 95% CI 0.6 to 0.98) were significantly less for patients with right-sided lesions. In conclusion, patients with right-sided lesions had a greater lifetime burden of AAs. However, their morbidity and mortality were no less than those with left-sided lesions, although the rate of intervention was substantially different.
Keywords
Aged, Atrial Fibrillation/epidemiology, Atrial Fibrillation/etiology, Female, Heart Atria, Heart Defects, Congenital/complications, Humans, Male, Middle Aged, Prevalence, Prognosis, Quebec/epidemiology, Tachycardia, Supraventricular/epidemiology, Tachycardia, Supraventricular/etiology
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Web of science
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14/05/2014 11:02
Last modification date
20/08/2019 16:08
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