Author + information
- Shankar Baskar,
- Philippa Horne,
- Samantha Fitzsimmons,
- Philip Khoury,
- Joseph Vettukattill,
- Koichiro Niwa,
- Teiji Agaki,
- Mark Spence and
- Gruschen Veldtman
Objective: Patients with Eisenmenger syndrome (ES) have a shorter life-span than the general population. A significant proportion develop arrhythmia and some, sudden death. Despite these observations, studies characterizing arrhythmias and their prognostic value in ES are lacking.
Methods: This retrospective study included patients aged ≥ 18 years of age with ES from Southampton University Hospital, the Japanese Adult Congenital Heart group and Belfast, Northern Ireland. Information was collected from chart review and arrhythmias were noted from clinical encounters, electrocardiograms and Holter study reviews.
Results: A total of 167 patients, 95 females, 63 males (gender not available in 9 patients) were included in this study. The mean age was 37 ± 10 years (range: 18 – 63 years) with a majority in NYHA functional class II or III (57% and 32% respectively) and mean oxygen saturation of 85±7 %. Twenty eight patients (17%) had a documented history of arrhythmia: paroxysmal supraventricular tachycardia (8 patients, 29%), atrial fibrillation (6 patients, 21%), atrial fibrillation and flutter (2 patients, 7%), non-sustained ventricular tachycardia (6 patients, 21%) and sustained ventricular tachycardia (6 patients, 21%). Twenty-five of the patients (15%) were on anti-arrhythmic therapy and 77 patients (49%) were on disease targeting therapy for pulmonary hypertension. Downs syndrome was present in 76 patients (46%). Patients with arrhythmia were older [p=0.01] and were more likely to have atrioventricular valvar regurgitation [Odds ratio: 4.33]. Arrhythmias were found to independently predict all-cause mortality [p=0.004] and sudden death in bivariate analysis [p=0.03]. Disease targeting therapy was a protective factor against all-cause mortality in logistic regression analysis [Odds ratio: 0.31], while anti-arrhythmics predicted sudden death [Odds ratio: 6.24].
Conclusions: Arrhythmias are common among patients with ES, with atrio-ventricular valve regurgitation being a risk-factor. Arrhythmias may predict sudden death, the risk of which is not reduced by being on anti-arrhythmics.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: The Story of the Adult Congenital Heart Disease Patient and EP
Abstract Category: 9. Congenital Heart Disease: Adult
Presentation Number: 1102-021
- 2017 American College of Cardiology Foundation