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  • Open Access

    ARTICLE

    Postoperative and short‐term atrial tachyarrhythmia burdens after transcatheter vs surgical pulmonary valve replacement among congenital heart disease patients

    Subeer K. Wadia1, Gentian Lluri1, Jamil A. Aboulhosn1, Hillel Laks2, Reshma M. Biniwale2, Glen S. Van Arsdell2, Daniel S. Levi3, Morris M. Salem3, Kevin M. Shannon1,3, Jeremy P. Moore1,3

    Congenital Heart Disease, Vol.14, No.5, pp. 838-845, 2019, DOI:10.1111/chd.12818

    Abstract Objective: We examined the atrial tachyarrhythmia (AT) burden among patients with congenital heart disease (CHD) following transcatheter (TC‐) or surgical (S‐) pulmo‐ nary valve replacement (PVR).
    Design/Setting: This was a retrospective observational study of patients who under‐ went PVR from 2010 to 2016 at UCLA Medical Center.
    Patients: Patients of all ages who had prior surgical repair for CHD were included. Patients with a history of congenitally corrected transposition of the great arteries, underwent a hybrid PVR procedure, or had permanent atrial fibrillation (AF) without a concomitant ablation were excluded.
    Outcome Measures: The primary outcome was a time‐to‐event analysis… More >

  • Open Access

    ARTICLE

    Detection of arrhythmias in adult congenital heart disease patients with LINQTM implantable loop recorder

    Anudeep K. Dodeja1, Courtney Thomas1, Curt J. Daniels1,2, Naomi Kertesz1,2, Anna Kamp1,2

    Congenital Heart Disease, Vol.14, No.5, pp. 745-751, 2019, DOI:10.1111/chd.12815

    Abstract Background: Rhythm disorders are the leading cause of morbidity and mortality in adults with congenital heart disease (ACHD). Infrequent or asymptomatic arrhyth‐ mias may not be detected by routine monitoring. Implantable loop recorders (ILRs), such as the Reveal LINQTM, have been useful in long‐term monitoring for arrhythmias in adults with cryptogenic stroke.
    Objective: We propose the Reveal LINQTM will detect arrhythmias, not documented by other monitoring modalities, resulting in change in management in ACHD patients.
    Methods: This is a single center retrospective review of Reveal LINQTM use in ACHD patients from 2014‐2017. Medical records were reviewed to determine cardiac… More >

  • Open Access

    ARTICLE

    Dysrhythmias in patients with a complete atrioventricular septal defect: From surgery to early adulthood

    Charlotte A. Houck1,2, Reinder Evertz3, Christophe P. Teuwen1, Jolien W. Roos‐Hesselink1, Janneke A. E. Kammeraad4, Anthonie L. Duijnhouwer3, Natasja M. S. de Groot3, Ad J. J. C. Bogers2

    Congenital Heart Disease, Vol.14, No.2, pp. 280-287, 2019, DOI:10.1111/chd.12724

    Abstract Objective: Outcomes after surgical repair of complete atrioventricular septal defect (cAVSD) have improved. With advancing age, the risk of development of dysrhythmias may increase. The aims of this study were to (1) examine development of sinus node dysfunction (SND), atrial and ventricular tachyarrhythmias, and (2) study progression of atrioventricular conduction abnormalities in young adult patients with repaired cAVSD.
    Study design: In this retrospective multicenter study, 74 patients (68% female) with a cAVSD repaired in childhood were included. Patients’ medical files were evaluated for occurrence of SND, atrioventricular conduction block (AVB), atrial and ventricular tachyarrhythmias.
    Results: Median age at… More >

  • Open Access

    ARTICLE

    Predictors and rates of recurrence of atrial arrhythmias following catheter ablation in adults with congenital heart disease

    Matthew Lewis1, William Whang2, Angelo Biviano2, Kathleen Hickey2, Hasan Garan2, Marlon Rosenbaum1

    Congenital Heart Disease, Vol.14, No.2, pp. 207-212, 2019, DOI:10.1111/chd.12695

    Abstract Background: Catheter ablation is commonly performed to treat atrial arrhythmias in adult congenital heart disease (ACHD). Despite the frequency of ablations in the ACHD population, predictors of recurrence remain poorly defined.
    Objective: We sought to determine predictors of arrhythmia recurrence in ACHD patients following catheter ablation for atrial arrhythmias.
    Methods: We performed a retrospective study of all catheter ablations for atrial arrhythmias performed in ACHD patients between January 12, 2005 and February 11, 2015 at our institution. Prespecified exposures of interest and time from ablation to recurrence were determined via chart review.
    Results: Among 124 patients (mean age: 45… More >

  • Open Access

    ARTICLE

    Anticoagulation practices in adults with congenital heart disease and atrial arrhythmias in Switzerland

    Ketina Arslani1*, Lukas Notz1*, Marzena Zurek1, Matthias Greutmann2, Markus Schwerzmann3, Judith Bouchardy4, Reto Engel5, Christine Attenhofer Jost6, Daniel Tobler1

    Congenital Heart Disease, Vol.13, No.5, pp. 678-684, 2018, DOI:10.1111/chd.12627

    Abstract Background: In adults with congenital heart disease (CHD) and atrial arrhythmias, recommendations for thromboprophylaxis are vague and evidence is lacking. We aimed to identify factors that influence decision-making in daily practice.
    Methods: From the Swiss Adult Congenital HEart disease Registry (SACHER) we identified 241 patients with either atrial fibrillation (Afib) or atrial flutter/intraatrial reentrant tachycardia (Aflut/ IART). The mode of anticoagulation was reviewed. Logistic regression models were used to assess factors that were associated with oral anticoagulation therapy.
    Results: Compared with patients with Aflut/IART, patients with Afib were older (51 ± 16.1 vs 37 ± 16 years, P… More >

  • Open Access

    ARTICLE

    Arrhythmia burden and related outcomes in Eisenmenger syndrome

    Shankar Baskar1, Philippa Horne2, Samantha Fitzsimmons3, Philip R. Khoury1, Joseph Vettukattill4, Koichiro Niwa5, Teiji Agaki6, Mark Spence7, Hisanori Sakazaki8, Gruschen Veldtman1

    Congenital Heart Disease, Vol.12, No.4, pp. 512-519, 2017, DOI:10.1111/chd.12481

    Abstract Background: Patients with Eisenmenger syndrome have a shorter lifespan than the general population. A significant proportion develop arrhythmia and some, sudden death.
    Objective: The aims of this study were to characterize the frequency, type and effects of arrhythmias in adult patients with Eisenmenger’s syndrome and to identify risk factors for arrhythmias.
    Methods: This retrospective study included patients aged ≥18 years of age with Eisenmenger’s syndrome from three institutions. Arrhythmias were noted from electrocardiograms and Holter study reviews.
    Results: A total of 167 patients, 96 females, 63 males (gender not available in 9 patients) were included in this study. The… More >

  • Open Access

    ARTICLE

    Analysis of adults with congenital heart disease presenting to pediatric emergency departments with arrhythmias

    Shaun Mohan1, Brady S. Moffett2, Wilson Lam2, Caridad de la Uz2, Christina Miyake2, Santiago O. Valdes2, Jeffrey J. Kim2

    Congenital Heart Disease, Vol.12, No.4, pp. 507-511, 2017, DOI:10.1111/chd.12478

    Abstract Objective: As survivors of congenital heart disease (CHD) continue to age, healthcare utilization by this population has increased. It is unknown how often these patients utilize the emergency department (ED) at children’s hospitals and how arrhythmias play a role in their utilization of care.
    Design: Using a retrospective cohort design, the Pediatric Hospital Information System (PHIS) database was investigated and we studied adults (≥18 years) with CHD (ACHD) who presented to pediatric EDs from 2004 to 2014.
    Setting: Tertiary care pediatric hospitals.
    Results: Of the 6310 encounters to pediatric EDs, 1594 (25%) were for arrhythmias. The median age was… More >

  • Open Access

    ARTICLE

    Electrocardiographic early repolarization characteristics and clinical presentations in the young: a benign finding or worrisome marker for arrhythmias

    Raya Safa, Ronald Thomas, Peter P. Karpawich

    Congenital Heart Disease, Vol.12, No.1, pp. 99-104, 2017

    Abstract Background: The early ECG repolarization QRS pattern (ERp), with J-point elevation of 0.1 mV in two contiguous inferior and/or lateral leads, can be associated with ventricular arrhythmias among adults. The significance of an ERp in the young is unknown.
    Objective: The purpose of this study was to assess the prevalence of ERp among young patients (pts), describe and correlate the characteristics with clinical presentations and any arrhythmias.
    Methods: This was a 1 y retrospective review of ECGs obtained from patients referred specifically for documented arrhythmias, possible arrhythmia-related symptoms or sports clearance. ECGs were analyzed for ERp (J-point, ascending/horizontal… More >

  • Open Access

    ARTICLE

    Sudden cardiac death and late arrhythmias after the Fontan operation

    Kavitha N. Pundi1, Krishna N. Pundi2, Jonathan N. Johnson1,3, Joseph A. Dearani4, Zhuo Li, BS5, David J. Driscoll1, Philip L. Wackel1, Christopher J. McLeod3, Frank Cetta1,3, Bryan C. Cannon1,3

    Congenital Heart Disease, Vol.12, No.1, pp. 17-23, 2017

    Abstract Objectives: We sought to examine the incidence and predictors of arrhythmias and sudden cardiac death (SCD) after Fontan operation.
    Background: Arrhythmias and SCD have been reported following operations for congenital heart disease, but the incidence and risk factors have not been well defined in patients after a Fontan operation.
    Methods: We reviewed records of all patients who had a Fontan operation from 1973 to 2012 (n 5 1052) at our institution. A questionnaire was mailed to patients who were not known to be deceased at the initiation of the study. Late arrhythmias were classified as bradyarrhythmias or tachyarrhythmias… More >

  • Open Access

    ARTICLE

    Ungated extracorporeal shock wave lithotripsy: safe and effective in the pediatric population

    Jeffrey S. Palmer

    Canadian Journal of Urology, Vol.16, No.6, pp. 4924-4926, 2009

    Abstract Purpose: Ungated extracorporeal shock wave lithotripsy (SWL) is unsynchronized to the patient's electrocardiogram. Although ungated extracorporeal shock wave lithotripsy (SWL) is associated with cardiac arrhythmias in adults, the incidence of arrhythmias in children has not been established. We report on the safety and efficacy of ungated SWL of renal calculi in children.
    Materials and methods: We evaluated all children less than 18 years of age undergoing ungated SWL for renal calculi. Lithotripsy with gradual incremental energy increase was used to treat the stones. Patients were monitored for arrhythmias and other standard monitoring intraoperatively and postoperatively.
    Results: Twenty-four consecutive… More >

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