Congenital heart disease was associated with a significantly higher risk of supraventricular (HR 8.0; 95% CI 7.6–8.5) and ventricular arrhythmias (HR 13.0; 95% CI 11.2–15.2) compared to controls.
Cohort (n=646,531)
Does congenital heart disease increase the risk of arrhythmias compared to the general population, and how do temporal trends affect this risk?
Patients with congenital heart disease have a markedly increased risk of both supraventricular and ventricular arrhythmias compared to the general population, although this risk has decreased for those born in 1990 or later.
Effect estimate: HR 8.0 (95% CI 7.6-8.5)
Abstract Background Arrhythmias constitute a significant concern in patients with congenital heart disease (CHD) but temporal trends remain unknown. Methods In a population-based cohort study, patients diagnosed with CHD (n=63,431) born in 1970–2017 were identified in the Swedish National Patient Register. Each patient was matched by age and sex with 10 control subjects (n=583,100) from the general population. Fine–Gray competing risk and Cox proportional-hazards regression were used; risk estimates were compared with matched controls. Results During median follow-up of 19 years (total range: 0-53 years), 1,895 new events of supraventricular arrhythmias were registered, yielding a hazard ratio (HR) of 8.0 (95% confidence interval CI 7.6–8.5), along with 371 new ventricular arrhythmias (HR 13.0; 95% CI 11.2–15.2). Complex CHD was associated with higher risk, irrespective of type, than non-complex CHD, and patients born in 1990 or later displayed lower risk for both supraventricular and ventricular arrhythmias, irrespective of age and CHD complexity, than those born before 1990. Patients aged 18–39 years with non-complex and complex CHD born before 1990 displayed HRs of 6.9 (95% CI 6.1–7.8) and 23.9 (95% CI 19.4–29.5) for supraventricular arrhythmias, respectively, versus 3.2 (95% CI 2.7–3.9) and 13.9 (95% CI 9.8–19.7) in those born in 1990 or later. Conclusions The risk of arrhythmias was generally high across the CHD population and increased with increasing age and lesion complexity. Importantly, patients born in 1990 or later demonstrated lower risk for both supraventricular and ventricular arrhythmias than those born before 1990.
Eckerström et al. (Thu,) conducted a cohort in Congenital heart disease (n=646,531). Congenital heart disease vs. Matched general population controls was evaluated on Supraventricular arrhythmias (HR 8.0, 95% CI 7.6-8.5). Congenital heart disease was associated with a significantly higher risk of supraventricular (HR 8.0; 95% CI 7.6–8.5) and ventricular arrhythmias (HR 13.0; 95% CI 11.2–15.2) compared to controls.