Abstract 16630: Clinical Predictors of Intraatrial Reentrant Arrhythmias in Adults With Congenital Heart Disease
Background: Intraatrial reentrant tachycardias (IART) are a significant source of morbidity and mortality in adults with congenital heart disease (CHD). The aim of this study was to evaluate the incidence and clinical predictors of IART in a cohort of patients with CHD.
Methods: We conducted a retrospective analysis of 3,311 adults (median age at entry 22.6 years, 50.6% males) with CHD (49% simple, 39% moderate and 12% complex) followed-up in a tertiary center for 37,607 person-years. Predictors of IART were identified by multivariate logistic regression. An external validation was performed in a second cohort of 1,432 patients. ROC curves were used to assess the discriminative ability of model obtained. Survival curves were constructed by Kaplan-Meier method.
Results: Overall, 153 (4.6%) patients presented IART. Risk factors independently related to IART are presented in the Table. The model obtained showed excellent discrimination power (area under the ROC [AUC] curve 0.807, p<0.001) (Figure, panel A) and its predictive ability was confirmed in the validation cohort (AUC 0.754, p<0.001). IART incidence was 0.3%, 3%, 9% and 20% in patients 0, 1, 2 and ≥ 3 risk factors, respectively. Cumulative IART freedom is plotted in the Figure (panel B).
Conclusion: Simple clinical parameters such as univentricular physiology, systemic right ventricle, subaortic or subpulmonary ventricular dysfunction, pulmonary or subpulmonary AV valve regurgitation, previous intracardiac repair and pre-tricuspid shunt were independent predictors of IART in adults with CHD. While IART risk was negligible in patients without any of these factors, their addition progressively increased IART burden.
Author Disclosures: P. Ávila: None. J. Oliver: None. P. Gallego: None. A. González-García: None. M. Rodríguez-Puras: None. J. Ruíz-Cantador: None. A. Campos: None. R. Peinado: None. R. Prieto: None. F. Sarnago: None. R. Yotti: None. F. Fernández-Avilés: None.
- © 2016 by American Heart Association, Inc.