Document Detail

Rate of inducible ventricular arrhythmia in adults with congenital heart disease.
MedLine Citation:
PMID:  20723654     Owner:  NLM     Status:  MEDLINE    
Patients with adult congenital heart disease are at increased risk of ventricular arrhythmia (VA) and sudden cardiac death, although no clear predictors have been found. Ventricular programmed stimulation has been shown to predict clinical ventricular tachycardia and sudden death events, but the role of screening electrophysiology studies (S-EPSs) in this population remains poorly defined. Therefore, we sought to determine the prevalence of inducible VA and to evaluate the clinical predictors in a heterogeneous group of patients with adult congenital heart disease (> or =18 years old) undergoing S-EPSs at preoperative or interventional cardiac catheterization. Studies for the primary evaluation of clinical VA were excluded. The demographic, clinical, and diagnostic findings were compared between the patients with positive and negative findings. From 2005 to 2009, 80 patients (mean age 30 +/- 9 years) underwent S-EPSs, and 23 had inducible VA. The diagnoses for those with studies positive for VA included tetralogy of Fallot (n = 12), d-transposition of the great arteries (n = 6), pulmonary stenosis (n = 2), double outlet right ventricle (n = 1), double inlet left ventricle (n = 1), and Ebstein's anomaly (n = 1). Men were significantly more likely to have a S-EPS positive for VA (p = 0.015). Increasing QRS duration, decreasing peak oxygen uptake (percentage of predicted), and ventricular fibrosis with cardiovascular magnetic resonance imaging were significantly associated with studies positive for VA (p <0.05). Combined fibrosis and a peak oxygen uptake <80% of predicted had 100% sensitivity for positive VA findings. In conclusion, almost 30% of those with adult congenital heart disease undergoing S-EPSs had inducible VA. A prolonged QRS duration, diminished exercise capacity, and the presence of ventricular fibrosis were significantly associated with findings positive for VA and might improve patient selection for screening evaluations.
Shane F Tsai; David P Chan; Pamela S Ro; Bethany Boettner; Curt J Daniels
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Publication Detail:
Type:  Journal Article     Date:  2010-07-23
Journal Detail:
Title:  The American journal of cardiology     Volume:  106     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  730-6     Citation Subset:  AIM; IM    
Copyright Information:
2010 Elsevier Inc. All rights reserved.
Heart Center, Nationwide Children's Hospital, Columbus, Ohio, USA.
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MeSH Terms
Age Factors
Cohort Studies
Heart Catheterization
Heart Defects, Congenital / complications*,  pathology,  physiopathology
Retrospective Studies
Risk Factors
Sex Factors
Tachycardia, Ventricular / diagnosis,  epidemiology*,  physiopathology
Young Adult

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

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