Adults with congenital heart disease and atrial fibrillation were significantly more likely to be treated with oral anticoagulation compared to those with atrial flutter or intraatrial reentrant tachycardia (67% vs 43%, OR 2.75).
Observational (n=241)
Yes
What factors influence the use of oral anticoagulation therapy in adults with congenital heart disease and atrial arrhythmias?
In adults with congenital heart disease and atrial arrhythmias, CHA2DS2-VASc score, HAS-BLED score, and Fontan palliation significantly influence the decision to prescribe oral anticoagulation.
Odds Ratio: 2.75 (95% CI 1.3–5.08)
Absolute Event Rate: 67% vs 43%
p-value: p=0.007
BACKGROUND: In adults with congenital heart disease (CHD) and atrial arrhythmias, recommendations for thromboprophylaxis are vague and evidence is lacking. We aimed to identify factors that influence decision-making in daily practice. METHODS: From the Swiss Adult Congenital HEart disease Registry (SACHER) we identified 241 patients with either atrial fibrillation (Afib) or atrial flutter/intraatrial reentrant tachycardia (Aflut/IART). The mode of anticoagulation was reviewed. Logistic regression models were used to assess factors that were associated with oral anticoagulation therapy. RESULTS: -VASc-Score >1 OR 2.93, 95%CI (1.87-4.61), P 1 was associated with absence of thromboprophylaxis [OR 0.32, 95%CI (0.17-0.60), P < .001. CONCLUSIONS: -VASc and HAS-BLED scores as well as a Fontan palliation had an impact on the use of thromboprophylaxis in adult CHD patients with atrial arrhythmias. In daily practice, anticoagulation strategies differ between patients with Afib and those with Aflut/IART. Prospective observational studies are necessary to clarify whether this attitude is justified.
Arslani et al. (2018) conducted an observational in Congenital heart disease with atrial arrhythmias (n=241). Atrial fibrillation vs. Atrial flutter/intraatrial reentrant tachycardia (IART) was evaluated on Use of oral anticoagulation therapy (OR 2.75, 95% CI 1.30-5.08, p=0.007). Adults with congenital heart disease and atrial fibrillation were significantly more likely to be treated with oral anticoagulation compared to those with atrial flutter or intraatrial reentrant tachycardia (67% vs 43%, OR 2.75).