@Article{chd.12695,
AUTHOR = {Matthew Lewis, William Whang, Angelo Biviano, Kathleen Hickey, Hasan Garan, Marlon Rosenbaum},
TITLE = {Predictors and rates of recurrence of atrial arrhythmias following catheter ablation in adults with congenital heart disease},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {2},
PAGES = {207--212},
URL = {http://www.techscience.com/schd/v14n2/38762},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> 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.<br/>
<b>Objective:</b> We sought to determine predictors of arrhythmia recurrence in ACHD
patients following catheter ablation for atrial arrhythmias.<br/>
<b>Methods:</b> 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.<br/>
<b>Results:</b> Among 124 patients (mean age: 45 years) who underwent catheter ablation,
96 (77%) were treated for macro‐reentrant atrial tachycardia, 10 (7%) for focal atrial
tachycardia, 9 (7%) for atrial fibrillation, 7 (6%) for atrioventricular nodal reentrant
tachycardia, and 2 (2%) for atrioventricular reentrant tachycardia. 15 (12%) required
transseptal/transbaffle puncture. Fifty‐one percent of patients recurred with a median time to recurrence of 1639 days. By univariate and multivariable analysis, body
mass index (BMI) and Fontan status were the only variables associated with recurrence. Dose‐dependent effect was observed with overweight (HR = 2.37, P = .012),
obese (HR = 2.67, P = .009), and morbidly obese (HR = 4.23, P = .003) patients demonstrating an increasing risk for arrhythmia recurrence postablation. There was no
significant different in recurrence rates by gender, age, non‐Fontan diagnosis, or
need for transseptal puncture.<br/>
<b>Conclusions:</b> In our cohort of ACHD patients, BMI was a significant risk factor for
arrhythmia recurrence postablation, independent of Fontan status. These findings
may help guide treatment decisions for persistent arrhythmias in the ACHD
population.},
DOI = {10.1111/chd.12695}
}