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Circulation: Arrhythmia and Electrophysiology
Atrial tachycardias (ATs) are common in adults with congenital heart disease (CHD). This analysis of the incidence and clinical predictors of AT in patients with CHD identified and validated simple clinical parameters that are independent predictors of AT in adults with CHD. Patients without any of these factors had a very low risk of AT with a stepwise increase in incidence with increasing risk factors.
Natural History and Clinical Predictors of Atrial Tachycardia in Adults With Congenital Heart Disease
Pablo Ávila, MD
José María Oliver, MD, PhD
Pastora Gallego, MD, PhD
Ana González-García, MD
María José Rodríguez-Puras, MD
Esther Cambronero, MD
José Ruiz-Cantador, MD
Ana Campos, MD
Rafael Peinado, MD, PhD
Raquel Prieto, MD, PhD
Fernando Sarnago, MD
Raquel Yotti, MD, PhD
Francisco Fernández-Avilés, MD, PhD
Correspondence to: Pablo Ávila, MD, Department of Cardiology, Hospital General Universitario Gregorio Marañón, 46 Dr Esquerdo St, 28006 Madrid, Spain. E-mail firstname.lastname@example.org
BACKGROUND: Atrial tachycardias (ATs) are a significant source of morbidity in adults with congenital heart disease (CHD). This study evaluates the incidence and clinical predictors of AT in a cohort of patients with CHD.
METHODS AND RESULTS: We included 3311 adults (median age at entry 22.6 years, 50.6% males) with CHD (49% simple, 39% moderate, and 12% complex) prospectively followed up in a tertiary center for 37 607 person-years. Predictors of AT were identified by multivariable Cox regression analysis accounting for left truncation. An external validation was performed in a contemporary cohort of 1432 patients. Overall, 153 (4.6%) patients presented AT. AT burden was highest in complex CHD, such as single ventricle (22.8%) and D-transposition of the great arteries (22.1%). Hazard rates of AT across lifetime, age at presentation, and the time lapse between surgery and the first AT episode varied among the most common CHD. Independent risk factors for developing AT were univentricular physiology, previous intracardiac repair, systemic right ventricle, pulmonary hypertension, pulmonary regurgitation, pulmonary …