Characterization and comparison of rhythm disturbances after atrial or arterial switch surgeries for dextro-transposition of the great arteries: a long-term follow-up study Article Swipe
C Marques
,
Rui Pinto
,
T Proença
,
Margarida Carvalho
,
António Cabrita
,
Carolina Magalhães Costa
,
A F Amador
,
J Calvao
,
Catarina S. Oliveira
,
Leonardo D. Santos
,
A I Pinho
,
M Rocha
,
P Mangas Palma
,
Hugo Silva Assis Moreira
,
Cristina Cruz
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/eurheartj/ehad655.278
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/eurheartj/ehad655.278
Introduction and objectives Dextro-transposition of the great arteries (D-TGA) is a congenital heart disease (CHD) palliated with atrial switch (ATR-S) and, more recently, with arterial switch (ART-S). As late complications from ATR-S are expected, novel challenges from ART-S surgery arises. Our aim was to evaluate these patients’ (pts) arrhythmic disturbances after a long-term follow-up. Methods We retrospectively analyzed D-TGA pts born between 1974 and 2001 and followed in Adult CHD Outpatient Clinic at a tertiary care hospital. Clinical records were used to collect pts data. Results A total of 79 pts were enrolled with a mean follow-up time after surgery of 27±6 years. Pts median age was 27 years-old and 46% were female. 54% were submitted to ATR-S, while 46% underwent ART-S; median age at intervention was 13 months and 10 days, respectively. Focusing arrhythmic events (Table 1), almost all ART-S pts remained in sinus rhythm versus 64% of ATR-S (p=0.002). The latter presented significantly higher frequencies of arrythmias (41% vs 3%, p < 0.001), mainly atrial flutter or fibrillation (26% vs 0%), as well as bradyarrhythmias (12% vs 0%). Chronotropic incompetence was also more frequent after ATR-S (46% vs 9%, p=0.011). Inversely, intraventricular (IV) conduction disturbances were more frequent after ART-S (54% vs 15%, p < 0.001), the majority due to incomplete right bundle branch block. Cardiac Implantable Electronic Devices (CIED) were implanted in 6 pts (5 pacemakers and 1 implantable cardioverter defibrillator) and 1 patient was submitted to catheter ablation of cavotricuspid isthmus, all of them from ATR-S group. The overall median time to first arrhythmia was 23±9 years. Conclusion ATR-S presented significantly fewer pts in sinus rhythm and higher rates of chronotropic incompetence, as well as need for CIED. Additionally, ATR-S pts had higher rates of arrhythmia development, namely supraventricular (SV) ones. These findings highlight the advantages of ART-S over ATR-S in reducing SV arrhythmias occurrence. Curiously, IV conduction disturbances, mainly incomplete right bundle brunch block, were more frequent after ART-S. This fact emphasizes the importance of long-term follow-up of all pts, regardless of the initial surgical approach, as ART-S pts were not arrhythmic-free. Our work raises awareness for arrhythmic disturbances in this subgroup of CHD pts, irrespective of surgical strategy adopted.Table 1
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/eurheartj/ehad655.278
- https://academic.oup.com/eurheartj/article-pdf/44/Supplement_2/ehad655.278/53591383/ehad655.278.pdf
- OA Status
- bronze
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4388596176
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4388596176Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/eurheartj/ehad655.278Digital Object Identifier
- Title
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Characterization and comparison of rhythm disturbances after atrial or arterial switch surgeries for dextro-transposition of the great arteries: a long-term follow-up studyWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-11-01Full publication date if available
- Authors
-
C Marques, Rui Pinto, T Proença, Margarida Carvalho, António Cabrita, Carolina Magalhães Costa, A F Amador, J Calvao, Catarina S. Oliveira, Leonardo D. Santos, A I Pinho, M Rocha, P Mangas Palma, Hugo Silva Assis Moreira, Cristina CruzList of authors in order
- Landing page
-
https://doi.org/10.1093/eurheartj/ehad655.278Publisher landing page
- PDF URL
-
https://academic.oup.com/eurheartj/article-pdf/44/Supplement_2/ehad655.278/53591383/ehad655.278.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
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bronzeOpen access status per OpenAlex
- OA URL
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https://academic.oup.com/eurheartj/article-pdf/44/Supplement_2/ehad655.278/53591383/ehad655.278.pdfDirect OA link when available
- Concepts
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Medicine, Great arteries, Atrial flutter, Atrial fibrillation, Internal medicine, Cardiology, Sinus rhythm, Surgery, Heart diseaseTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- Related works (count)
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10Other works algorithmically related by OpenAlex
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