@Article{chd.12818,
AUTHOR = {Subeer K. Wadia, Gentian Lluri, Jamil A. Aboulhosn, Hillel Laks, Reshma M. Biniwale, Glen S. Van Arsdell, Daniel S. Levi, Morris M. Salem, Kevin M. Shannon, Jeremy P. Moore},
TITLE = {Postoperative and short‐term atrial tachyarrhythmia burdens after transcatheter vs surgical pulmonary valve replacement among congenital heart disease patients},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {14},
YEAR = {2019},
NUMBER = {5},
PAGES = {838--845},
URL = {http://www.techscience.com/schd/v14n5/38855},
ISSN = {3071-1738},
ABSTRACT = {<b>Objective:</b> 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).<br/>
<b>Design/Setting:</b> This was a retrospective observational study of patients who under‐
went PVR from 2010 to 2016 at UCLA Medical Center.<br/>
<b>Patients:</b> 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.<br/>
<b>Outcome Measures:</b> The primary outcome was a time‐to‐event analysis of sustained 
AT. Sustained ATs were defined as focal AT, intra‐atrial reentrant tachycardia/atrial 
flutter, or AF lasting at least 30 seconds or terminating with cardioversion or anti‐
tachycardia pacing.<br/>
<b>Results:</b> Two hundred ninety‐seven patients (TC‐PVR, n = 168 and S‐PVR, n = 129) 
were included. During a median follow‐up of 1.2 years, nine events occurred in 
TC‐PVR group (5%) vs 23 events in S‐PVR group (18%). In the propensity adjusted 
models, the following factors were associated with significant risk of AT after PVR: 
history of AT, age at valve implantation, severe right atrial enlargement, and S‐PVR. In 
the secondary analysis, TC‐PVR was associated with lower adjusted risk of AT events 
in the postoperative epoch (first 30 days), adjusted IRR 0.31 (0.14‐0.97), P = .03, but 
similar risk in the short‐term epoch, adjusted IRR 0.64 (0.14‐2.94), P = .57.<br/>
<b>Conclusion:</b> There was an increased risk of AT in the first 30 days following S‐PVR 
compared to TC‐PVR. Additional factors associated with risk of AT events after PVR 
were a history of AT, age at valve implantation, and severe right atrial enlargement.},
DOI = {10.1111/chd.12818}
}