Key result
In patients with Tetralogy of Fallot, atrial fibrillation progressed in 38% of cases within 5 years of onset, and rhythm control with antiarrhythmic drugs was ineffective in preventing progression.
Observational (n=29)
In patients with tetralogy of Fallot, postoperative atrial fibrillation develops at a young age and progresses rapidly despite pharmacological rhythm control.
Answers are grounded in this paper and cite their sources.
AF develops young with rapid progression in ToF despite AADs; leaves open optimal rhythm strategies for prospective study.
INTRODUCTION: ToF patients are at risk for ventricular deterioration at a relatively young age, which can be aggravated by AF development. Therefore, knowledge on AF development and its timespan of progression is essential to guide treatment strategies for AF. OBJECTIVE: We examined late postoperative AF onset and progression in ToF patients during long-term follow-up after ToF correction. In addition, coexistence of AF with regular supraventricular tachyarrhythmias (SVT) and ventricular tachyarrhythmias (VTA) was analyzed. METHODS AND RESULTS: ToF patients (N = 29) with AF after ToF correction referred to the electrophysiology department between 2000 and 2015 were included. All available rhythm registrations were reviewed for AF, regular SVT, and VTA. AF progression was defined as transition from paroxysmal AF to (longstanding) persistent/permanent AF or from (longstanding) persistent AF to permanent AF. At the age of 44 ± 12 years, ToF patients presented with paroxysmal (N = 14, 48%), persistent (N = 13, 45%) or permanent AF (N = 2, 7%). Age of AF development was similar among patients who either underwent initial shunt creation (N = 15, 45 ± 11 [25-57] years) or primary total ToF correction (N = 14, 43 ± 13 [26-66] years) (P = 0.785). AF coexisted with regular SVT (N = 18, 62%) and VTA (N = 13, 45%). Progression of AF occurred in 11 patients (38%) within 5 ± 5 years after AF onset despite antiarrhythmic drug class II (AAD, P = 0.052) or III (P = 0.587) usage. CONCLUSIONS: AF in our ToF population developed at a young age and showed rapid progression. Rhythm control by pharmacological therapy was ineffective in preventing AF progression.
No takes yet. Share an insight, caveat, or question.
Ramdjan et al. (2017) conducted an observational in Tetralogy of Fallot with atrial fibrillation (n=29). Antiarrhythmic drug therapy (class II or III) was evaluated on Progression of atrial fibrillation (transition to persistent or permanent AF). In patients with Tetralogy of Fallot, atrial fibrillation progressed in 38% of cases within 5 years of onset, and rhythm control with antiarrhythmic drugs was ineffective in preventing progression.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: