Abstract 17700: Right Atrial Volume in Tetralogy of Fallot Correlates With the Incidence of Supra-Ventricular Arrhythmia: A MRI Study
Introduction: Patients with corrected Tetralogy of Fallot (cTOF) frequently develop supra-ventricular arrhythmia. The role of right atrial (RA) volume in cTOF has not been evaluated in the context of arrhythmia in detail.
Hypothesis: Aim of this study was to evaluate if RA volume in cTOF correlates with the occurrence of supra-ventricular arrhythmia.
Methods: Cardiac magnetic-resonance imaging (CMRI) and 24h-Holter ECG monitoring were performed in n=67 consecutive cTOF patients. CMRI protocol included standard HASTE, SSFP Cine and blood flow measurements. Correlations were calculated between arrhythmia in ECG, heart volume and functional parameters. Additional parameters, such as left ventricular ejection fraction (LV EF), were evaluated in the analysis to identify further risk factors for arrhythmia.
Results: In all patients, mean value for RA volume was 49 ± 19 SD ml/m2 (HASTE), right ventricular volume 98 ± 27 SD ml/m2, pulmonary valve regurgitation fraction 21 ± 19 SD %, BMI 25 kg/m2, heart rate 75/min and n=66/67 patients had supra-ventricular arrhythmia presenting as singular extra-systoles (ES), couplets, short runs or longer lasting supra-ventricular (SV) tachycardia episodes. RA volume index was identified as an independent risk factor for different degrees of supra-ventricular arrhythmia (SVES p<0.001, SV couplets/runs p<0.001, SV tachycardia p<0.001). Further risk factors for supra-ventricular arrhythmia were BMI (p<0.02), male gender (p=0.023) and LV EF (p<0.01). Previous shunt surgery (p=0.015) correlated negatively with occurrence of arrhythmia.
Conclusions: A large RA volume in cTOF patients correlates well with the occurrence of supra-ventricular arrhythmia. SV-arrhythmia appears more often in cTOF patients with high BMI, male gender and decreased LV EF. Risk stratification according to these parameters could help to optimize prevention and adjust therapy to individually improve each patient’s quality of life.
- Pediatric cardiology
- Congenital heart disease
- Magnetic resonance imaging
- Ventricular arrhythmia
- Tetralogy of Fallot
- © 2013 by American Heart Association, Inc.