Abstract 14696: The Risk of Atrial Fibrillation in Young Patients With Congenital Heart Disease in Sweden
Introduction: Patients with congenital heart disease (CHD) are assumed to be a vulnerable group for atrial fibrillation (AF) due to residual shunts, different vessel anatomy, progressive valvulopathy, hypertension and atrial scars from previous heart operations. However, the risk of developing AF in children and young adults with CHD compared to controls has not been established.
Hypothesis: The aim of the present study was to estimate the risk of developing AF in children and young adults with CHD compared to matched controls.
Methods: Data from the Swedish Patient and Cause of Death Registers were used in order to identify all patients with a CHD diagnosis who were born between 1970 and 1993. Diagnoses were coded according to the International Statistical Classification of Diseases (ICD 8th, 9th, and 10th editions). Each patient with CHD was matched by age, sex, and county with 10 controls from the Total Population Register in Sweden who were without any diagnosis of CHD. Follow-up and comorbidity data were collected until 2011.
Results: Among 26,906 patients (51.3 % men) with CHD and 269,053 matched controls, 675 respective 449 developed AF; mean follow-up was 18.5 years. The risk to develop AF was 5.2 times higher (95% [CI] 3.3-8.4, p<0.001) in CHD patients compared to controls. The hazard ratio (HR) for AF in women and men with CHD was 5.2 (95% [CI] 2.9-9.3, p<0.001) and 5.3 (95% [CI] 2.4-11.8, p<0.001), respectively, compared to their controls. Only patients with complex conditions i.e. tetralogy of Fallot, transposition of the great vessels, double inlet ventricle, hypoplastic left heart syndrome, common arterial trunk, and atrioventricular septal defect had a significantly elevated risk to develop AF with a HR of 35.3 (95% [CI] 12.9-96.6, p<0.001).
Conclusions: the risk of AF in children and young adults with CHD was approximately 5 times higher compared to matched controls. The patient group with the most complex congenital defects carried most of the risk and had a significantly 35 times higher risk of AF and could be considered for targeted intervention.
Author Disclosures: Z. Mandalenakis: None. A. Rosengren: None. G. Lappas: None. P. Eriksson: None. T. Gilljam: None. K. Skoglund: None. M. Fedchenko: None. P. Hansson: None. M. Dellborg: None.
- © 2016 by American Heart Association, Inc.