Abstract
Atrial arrhythmias are common late sequelae of congenital heart disease (CHD), and several reports have documented their high prevalence in the late postoperative period. 1 Bink-Boelkens M.T. Meuzelaar K.J. Eygelaar A. Arrhythmias after repair of secundum atrial septal defect the influence of surgical modification. Am Heart J. 1988; 115: 629-633 Crossref PubMed Scopus (43) Google Scholar , 2 Roos-Hesselink J. Perlroth M.G. McGhie J. Spitaels S. Atrial arrhythmias in adults after repair of tetralogy of Fallot Correlations with clinical, exercise, and echocardiographic findings. Circulation. 1995; 91: 2214-2219 Crossref PubMed Scopus (225) Google Scholar , 3 Gelatt M. Hamilton R.M. McCrindle B.W. Connelly M. Davis A. Harris L. Gow R.M. Williams W.G. Trusler G.A. Freedom R.M. Arrhythmia and mortality after the Mustard procedure a 30-year single-center experience. J Am Coll Cardiol. 1997; 29: 194-201 Crossref PubMed Scopus (393) Google Scholar , 4 Gelatt M. Hamilton R.M. McCrindle B.W. Gow R.M. Williams W.G. Trusler G.A. Freedom R.M. Risk factors for atrial tachyarrhythmias after the Fontan operation. J Am Coll Cardiol. 1994; 24: 1735-1741 Crossref PubMed Scopus (231) Google Scholar These arrhythmias are associated with impaired quality of life, increased risk of thromboembolism, and death. They are difficult to control, with variable response to antiarrhythmic drug therapy, repeated cardioversion, and ablative and surgical intervention. The etiology, mechanism, and clinical significance of intra-atrial reentry tachycardia (IART) have been characterized in patients with CHD by epidemiologic study, 4 Gelatt M. Hamilton R.M. McCrindle B.W. Gow R.M. Williams W.G. Trusler G.A. Freedom R.M. Risk factors for atrial tachyarrhythmias after the Fontan operation. J Am Coll Cardiol. 1994; 24: 1735-1741 Crossref PubMed Scopus (231) Google Scholar in animal models, 5 Rodefeld M.D. Bromberg B.I. Schuessler R.B. Boineau J.P. Cox J.L. Huddleston C.B. Atrial flutter after lateral tunnel construction in the modified Fontan operation a canine model. J Thorac Cardiovasc Surg. 1996; 111: 514-526 Abstract Full Text Full Text PDF PubMed Scopus (82) Google Scholar and by electroanatomic mapping and ablation. 6 Love B.A. Collins K.K. Walsh E.P. Triedman J.K. Electroanatomic characterization of conduction barriers in sinus/atrially paced rhythm and association with intra-atrial reentrant tachycardia circuits following congenital heart disease surgery. J Cardiovasc Electrophysiol. 2001; 12: 17-25 Crossref PubMed Scopus (95) Google Scholar In contrast, atrial fibrillation (AF) is less well understood in these patients. This study describes a large cohort of patients with CHD with late atrial arrhythmias. We sought to identify the clinical and temporal characteristics that distinguish patients with AF and with IART, and to ascertain whether there was any temporal evolution between the 2 arrhythmias.
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