Long-term incidence of arrhythmias in extracardiac conduit Fontan and comparison between systemic left and right ventricle

C. Di Mambro, M. L. Yammine, P. P. Tamborrino, U. Giordano, D. Righi, M. Unolt, N. Cantarutti, S. Maiolo, S. Albanese, A. Carotti, Antonio Amodeo, L. Galletti, F. Drago

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Aims The extracardiac conduit-Fontan (ECC) has become the preferred technique for univentricular heart palliation, but there are currently no data on the incidence of long-term arrhythmias. This study investigated the incidence of arrhythmias and relation to single ventricle morphology in the long-term follow-up (FU) in ECC. Methods and results All patients with ECC performed in our Centre between 1987 and 2017 were included (minimum FU 5 years). Of 353 consecutive patients, 303 [57.8% males, aging 8-50 (median 20) years at last FU] were considered and divided into two groups depending on left (194 in Group 1) or right (109 in Group 2) ventricular morphology. Eighty-five (28%) experienced ≥1 arrhythmic complications, with early and late arrhythmias in 17 (5.6%) and 73 (24.1%) patients, respectively. Notably, late bradyarrhythmias occurred after 6 years in 21 (11%) patients in Group 1, and in 15 (13.8%) in Group 2 [P = 0.48]. Late tachyarrhythmias occurred in 55 (18.2%) patients after 12 years: 33 (17%) in Group 1 and 22 (20.2%) patients in Group 2 [P = 0.5]. Ventricular tachycardias (VT) were documented after 12.5 years in 14 (7.2%) patients of Group 1 and 15 (13.8%) of Group 2 [P = 0.06] with a higher incidence in Group 2 during the FU [P = 0.005]. Conclusion Extracardiac conduit is related to a significant arrhythmic risk in the long-term FU, higher than previously reported. Bradyarrhythmias occur earlier but are less frequent than tachyarrhythmias. Interestingly, patients with systemic right ventricle have a significantly higher incidence of VT, especially in a very long FU.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaEuropace
Volume26
DOI
Stato di pubblicazionePubblicato - 2024

Keywords

  • Arrhythmias
  • Extracardiac conduit-Fontan
  • Single ventricle
  • Fontan failure
  • Long-term outcomes
  • Fontan circulation

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