Document Detail

Atrial arrhythmias in adults with congenital heart disease.
MedLine Citation:
PMID:  19822808     Owner:  NLM     Status:  MEDLINE    
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.
Judith Bouchardy; Judith Therrien; Louise Pilote; Raluca Ionescu-Ittu; Giuseppe Martucci; Natalie Bottega; Ariane J Marelli
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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    
McGill Adult Unit for Congenital Heart Disease Excellence, McGill University Health Center and the Jewish General Hospital, Montreal, Quebec, Canada.
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MeSH Terms
Age Factors
Atrial Fibrillation / epidemiology*,  etiology*
Cohort Studies
Follow-Up Studies
Heart Defects, Congenital / complications*,  epidemiology*
Middle Aged
Population Surveillance
Retrospective Studies
Young Adult
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

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