Abstract 13312: Risk Factors for the Development of Tachyarrhythmia Following the Norwood Procedure in the Single Ventricle Reconstruction Trial
Background: Tachyarrhythmias are an important contributor to morbidity following the Norwood procedure for single ventricle congenital heart disease. The purpose of this study was to determine what demographic, preoperative, or operative factors may be associated with the development of postoperative tachyarrhythmias in this population.
Methods: We performed a retrospective analysis of data collected prospectively through the multicenter Pediatric Heart Network Single Ventricle Reconstruction Trial for infants undergoing a Norwood procedure in 2005-2008. Our primary outcome of interest was any documented tachyarrhythmia requiring treatment or intervention during the inpatient postoperative stay. Subjects with a documented preoperative tachyarrhythmia (n=15) were excluded. After performing univariate chi-square analyses on a variety of candidate factors, we conducted multivariate stepwise logistic regression, including spline terms for nonlinearly associated variables, to calculate the adjusted odds ratios for the final variables.
Results: Of 529 subjects, 108 (20%) had at least one documented tachyarrhythmia, with 11 having more than one. Tachyarrhythmias included: 77 supraventricular tachycardia, 23 junctional ectopic tachycardia, 10 atrial flutter, 7 ventricular tachycardia, and 2 atrial fibrillation. In the final multivariate model (c-statistic=0.65), significant factors associated with arrhythmia included receiving a modified Blalock-Taussig shunt, use of ultrafiltration, and age. (Table)
Conclusions: Tachyarrhythmias are common following the Norwood procedure and are associated with the modifiable risk factors of shunt type and use of ultrafiltration. In addition, when surgery is performed between 8 and 20 days of age, older age is associated with a decreasing risk for tachyarrhythmia.
- Pediatric electrophysiology
- Pediatric cardiac intensive care
- Hypoplastic left heart
- Congenital heart surgery
Author Disclosures: M. Oster: None. S. Chen: None. D. Pober: None. Y. Bar-Cohen: None. M. Brothers: None. N. Cain: None. S. Colan: None. R. Czosek: Research Grant; Modest; Medtronic research grant. J. Decker: None. D. Gamboa: None. S. Idriss: Honoraria; Modest; St. Jude. J. Kirsh: Ownership Interest; Significant; Johnson & Johnson stock. M. LaPage: None. R. Ohye: Consultant/Advisory Board; Modest; Sorin, Inc.. E. Radojewski: None. M. Shah: Research Grant; Significant; Medtronic research grant. E. Silver: None. A. Singh: None. J. Temple: None. J. Triedman: Consultant/Advisory Board; Modest; Biosense Webster, Boehringer Ingelheim. J. Kaltman: None.
- © 2014 by American Heart Association, Inc.