Older age was independently associated with atrial fibrillation in patients with congenital heart disease (OR 1.024 per year; 95% CI 1.010-1.039; P=0.001).
Cohort (n=482)
Blinded adjudication
Yes
In patients with congenital heart disease, intra-atrial re-entrant tachycardia is the most common presenting atrial arrhythmia, but atrial fibrillation and permanent arrhythmias become increasingly prevalent with advancing age.
Odds Ratio: 1.024 (95% CI 1.01–1.039)
p-value: p=0.001
BACKGROUND: Atrial arrhythmias are the most common complication encountered in the growing and aging population with congenital heart disease. OBJECTIVES: This study sought to assess the types and patterns of atrial arrhythmias, associated factors, and age-related trends. METHODS: A multicenter cohort study enrolled 482 patients with congenital heart disease and atrial arrhythmias, age 32.0 ± 18.0 years, 45.2% female, from 12 North American centers. Qualifying arrhythmias were classified by a blinded adjudicating committee. RESULTS: The most common presenting arrhythmia was intra-atrial re-entrant tachycardia (IART) (61.6%), followed by atrial fibrillation (28.8%), and focal atrial tachycardia (9.5%). The proportion of arrhythmias due to IART increased with congenital heart disease complexity from 47.2% to 62.1% to 67.0% in patients with simple, moderate, and complex defects, respectively (p = 0.0013). Atrial fibrillation increased with age to surpass IART as the most common arrhythmia in those ≥50 years of age (51.2% vs. 44.2%; p < 0.0001). Older age (odds ratio OR: 1.024 per year; 95% confidence interval CI: 1.010 to 1.039; p = 0.001) and hypertension (OR: 2.00; 95% CI: 1.08 to 3.71; p = 0.029) were independently associated with atrial fibrillation. During a mean follow-up of 11.3 ± 9.4 years, the predominant arrhythmia pattern was paroxysmal in 62.3%, persistent in 28.2%, and permanent in 9.5%. Permanent atrial arrhythmias increased with age from 3.1% to 22.6% in patients <20 years to ≥50 years, respectively (p < 0.0001). CONCLUSIONS: IART is the most common presenting atrial arrhythmia in patients with congenital heart disease, with a predominantly paroxysmal pattern. However, atrial fibrillation increases in prevalence and atrial arrhythmias progressively become permanent as the population ages.
“Atrial fibrillation increases in prevalence and atrial arrhythmias progressively become permanent as the population ages.”
Labombarda et al. (Tue,) conducted a cohort in Congenital heart disease and atrial arrhythmias (n=482). Older age vs. Younger age was evaluated on Atrial fibrillation (OR 1.024, 95% CI 1.010-1.039, p=0.001). Older age was independently associated with atrial fibrillation in patients with congenital heart disease (OR 1.024 per year; 95% CI 1.010-1.039; P=0.001).