Document Detail


Atrial arrhythmias in adults with congenital heart disease.
MedLine Citation:
PMID:  19822808     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Atrial arrhythmias increase disease burden in the general adult population. Adults with congenital heart lesions constitute a rapidly growing group of patients with cardiovascular disease. We hypothesized that atrial arrhythmias increase with age and impair health outcomes in this population. METHODS AND RESULTS: We conducted a population-based analysis of prevalence, lifetime risk, mortality, and morbidity associated with atrial arrhythmias in adults with congenital heart disease from l983 to 2005. In 38 428 adults with congenital heart disease in 2005, 5812 had atrial arrhythmias. Overall, the 20-year risk of developing atrial arrhythmia was 7% in a 20-year-old subject and 38% in a 50-year-old subject. More than 50% of patients with severe congenital heart disease reaching age 18 years developed atrial arrhythmias by age 65 years. In patients with congenital heart disease, the hazard ratio of any adverse event in those with atrial arrhythmias compared with those without was 2.50 (95% confidence interval, 2.38 to 2.62; P<0.0001), with a near 50% increase in mortality (hazard ratio, 1.47; 95% confidence interval, 1.37 to 1.58; P<0.001), more than double the risk of morbidity (stroke or heart failure) (hazard ratio, 2.21; 95% confidence interval, 2.07 to 2.36; P<0.001), and 3 times the risk of cardiac interventions (hazard ratio, 3.00; 95% confidence interval, 2.81 to 3.20; P<0.001). CONCLUSIONS: Atrial arrhythmias occurred in 15% of adults with congenital heart disease. The lifetime incidence increased steadily with age and was associated with a doubling of the risk of adverse events. An increase in resource allocation should be anticipated to deal with this increasing burden.
Authors:
Judith Bouchardy; Judith Therrien; Louise Pilote; Raluca Ionescu-Ittu; Giuseppe Martucci; Natalie Bottega; Ariane J Marelli
Related Documents :
1295118 - Approaches to experimental arrhythmias in heart failure.
18806818 - Peroxynitrite: in vivo cardioprotectant or arrhythmogen?
11346318 - Palpitations, arrhythmias, and awareness of cardiac activity.
6707928 - Effects of stellectomy on cardiac rhythm disturbances induced by ouabain in guinea pigs.
16297808 - Reduced myocardial blood flow during left ventricular assist device support: a possible...
9692458 - Heparin-coated bypass circuits: effects on inflammatory response in pediatric cardiac o...
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-12
Journal Detail:
Title:  Circulation     Volume:  120     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-27     Completed Date:  2009-11-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1679-86     Citation Subset:  AIM; IM    
Affiliation:
McGill Adult Unit for Congenital Heart Disease Excellence, McGill University Health Center and the Jewish General Hospital, Montreal, Quebec, Canada.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Atrial Fibrillation / epidemiology*,  etiology*
Cohort Studies
Female
Follow-Up Studies
Heart Defects, Congenital / complications*,  epidemiology*
Humans
Male
Middle Aged
Population Surveillance
Retrospective Studies
Young Adult
Comments/Corrections
Comment In:
Circulation. 2009 Oct 27;120(17):1649-50   [PMID:  19822805 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Suppression of phosphoinositide 3-kinase prevents cardiac aging in mice.
Next Document:  Determinants of surgical outcome in patients with isolated tricuspid regurgitation.