scholarly journals Incidence, risk factors and outcomes of atrial arrhythmias in adult patients with atrioventricular septal defect

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
E Jacquemart ◽  
F Bessiere ◽  
N Combes ◽  
M Ladouceur ◽  
L Iserin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adult Congenital Heart Disease ◽  
Pacemaker Implantation ◽  
Atrioventricular Septal Defect ◽  
Adult Patients ◽  
Atrial Arrhythmia ◽  
Public Institution ◽  
Right Atrial ◽  
Atrial Arrhythmias ◽  
Logistic Regression Models

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): French Federation of Cardiology Background The number of adults with atrioventricular septal defects (AVSD) is growing, with however, very few data regarding the natural history of atrial arrhythmias in this specific population. We aimed to assess the incidence, associated factors and outcomes of atrial arrhythmias among adult patients with AVSD. Methods Multicentric retrospective cohort of patients with AVSD from 3 referral centers specialized in adult congenital heart disease. Unbalanced AVSD, univentricular hearts, and Eisenmenger syndromes were excluded. Lifetime cumulative incidences of different types of atrial arrhythmia (>30 seconds) were analyzed (atrial fibrillation [AF] and intra atrial reentrant tachycardia/focal atrial tachycardia [IART/FAT]). Multiple logistic regression models were used to identify risk factors for atrial arrhythmias. Results The cohort comprised of 391 patients (61.6% of women) with a mean age of 36.3 ± 16.3 years and 17.3 ± 14.2 years of follow-up after surgical repair in operated patients, including 333 (85.1%) partial/intermediate and 58 (1.0%) complete AVSD. Overall, atrial arrhythmias were documented in 98 patients (25.1%). The lifetime risks for developing atrial arrhythmia to ages 20, 40, and 60 were 3.7%, 17.6%, and 54.8%. IART/FAT was the leading arrhythmia until the age of 45 then AF surpassed IART/FAT. Age (OR = 1.4, 95%CI = 1.2-1.6 by 5 years increment), the number of cardiac surgeries (OR = 4.1, 95%CI = 2.5-6.9), left atrial dilatation (OR = 3.1, 95%CI = 1.4-6.8), right atrial dilatation (OR = 4.1, 95%CI = 1.7-10.3), and moderate or severe left AV valve regurgitation (OR = 3.7, 95%CI = 1.2-11.7) were independently associated with a higher risk of atrial arrhythmias. Patients with atrial arrhythmias more frequently had pacemaker implantation (41.8% vs. 8.5%, p < 0.001), heart failure (24.5% vs 1.0%, p < 0.001) and cerebrovascular accidents (11.2% vs 3.4%, p = 0.007). Conclusions The lifetime risk of atrial arrhythmias in patients with AVSD is considerable with more than half of patients who will develop an atrial arrhythmia by the age of 60. Atrial arrhythmias are associated with a significant morbidity in this population. Abstract Figure. Central Illustration AVSD

Incidence, Risk Factors, and Outcomes of Atrial Arrhythmias in Adult Patients With Atrioventricular Septal Defect

2021 ◽  
Author(s):  
Etienne Jacquemart ◽  
Francis Bessière ◽  
Nicolas Combes ◽  
Magalie Ladouceur ◽  
Laurence Iserin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Adult Patients ◽  
Atrial Arrhythmias ◽  
Incidence Risk

Stroke in patients with secundum atrial septal defect and sequelae after transcatheter closure

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319050
Author(s):  
Stephen J Dolgner ◽  
Zachary Louis Steinberg ◽  
Thomas K Jones ◽  
Mark Reisman ◽  
Jonathan Buber
Keyword(s):  
Risk Factors ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Lifestyle Changes ◽  
Adult Patients ◽  
Atrial Arrhythmias ◽  
Secundum Atrial Septal Defect ◽  
Eustachian Valve ◽  
Increased Risk ◽  
Asd Closure

ObjectiveTo evaluate the frequency of and risk factors for stroke as a presenting feature in adult patients with secundum atrial septal defect (ASD); rates of post-closure atrial fibrillation (AF) and stroke were also assessed.MethodsWe retrospectively reviewed adult patients who presented with an ASD between 2002 and 2018, excluding those with known atrial arrhythmias. Risk factors for stroke were identified using multivariable logistic regression. Post-closure stroke was evaluated using survival analysis stratified by the presence of post-procedure AF.ResultsOf 346 patients with ASD (median age 44 years), 34 (10%) presented with a history of stroke. Independent risk factors included elevated body mass index over 25 (OR: 18.2; 95% CI: 4.0 to 82.2; p<0.001), smoking (OR: 9.5; 95% CI: 3.8 to 23.9; p<0.001) and a prominent Eustachian valve (OR: 9.2; 95% CI: 3.4 to 25.2; p<0.001). A scoring system based on these three parameters provided robust stroke risk stratification. During a median follow-up of 12 months after closure, 12 patients (4%) experienced AF and 4 patients (1%) had a new stroke. AF was highly associated with development of stroke post-closure (p<0.001).ConclusionsIn this study population, the incidence of stroke prior to ASD closure among patients without atrial arrhythmias was 10%. Risk factors included obesity, smoking and prominent Eustachian valve anatomy. Lifestyle changes should be recommended for at-risk patients, and it may be reasonable to consider ASD closure in the absence of haemodynamic indications in patients at increased risk of stroke.

scholarly journals Atrial arrhythmias and thromboembolic complications in adults post Fontan surgery

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001224
Author(s):  
Darryl Wan ◽  
Jasmine Grewal ◽  
Amanda Barlow ◽  
Marla Kiess ◽  
Derek Human ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adult Population ◽  
Fontan Operation ◽  
Fontan Circulation ◽  
Atrial Arrhythmia ◽  
Atrial Arrhythmias ◽  
Thromboembolic Events ◽  
Thromboembolic Complications ◽  
Lateral Tunnel ◽  
Fontan Surgery

ObjectivePatients with Fontan surgery experience late complications in adulthood. We studied the factors associated with the development and maintenance of atrial arrhythmias and thromboembolic complications in an adult population with univentricuar physiology post Fontan surgery.MethodsSingle centre retrospective cohort study of patients ≥18 years of age with Fontan circulation followed at our quaternary care centre for more than 1 year were included. Univariate and multivariate regression models were used where applicable to ascertain clinically significant associations between risk factors and complications.Results93 patients were included (age 30.2±8.8 years, 58% men). 28 (30%) had atriopulmonary Fontan connection, 35 (37.6%) had lateral tunnel Fontan and 29 (31.1%) had extracardiac Fontan pathway. After a mean of 7.27±5.1 years, atrial arrhythmia was noted in 37 patients (39.8%), of which 13 developed had atrial fibrillation (14%). The presence of atrial arrhythmia was associated with the number of prior cardiac surgeries/procedures, increasing age and prior atriopulmonary Fontan operation. Thromboembolic events were present in 31 patients (33%); among them 14 had stroke (45%), 3 had transient ischaemic attack (9.7%), 7 had pulmonary embolism (22.6%) and 5 had atrial thrombus with imaging (16.1%). The presence of thromboembolic events was only associated with age and the presence of cirrhosis in multivariate analysis.ConclusionsAtrial arrhythmias are common in adults with Fontan circulation at an early age, and are associated with prior surgical history and increasing age. Traditional risk factors may not be associated with atrial arrhythmia or thromboembolism in this cohort.

Abstract 17376: Atrial Arrhythmias in SCAD Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Alex D Tarabochia ◽  
Nicholas Y Tan ◽  
Sharonne N Hayes ◽  
Patricia J Best ◽  
Rajiv Gulati ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
Cardiovascular Risk Factors ◽  
Artery Bypass ◽  
Atrial Arrhythmia ◽  
Data Repository ◽  
Artery Dissection ◽  
Atrial Arrhythmias ◽  
Coronary Syndrome

Introduction: Spontaneous coronary artery dissection (SCAD) is an uncommon but increasingly recognized cause of acute coronary syndrome and sudden cardiac death. We aim to review the occurrence of atrial fibrillation and atrial flutter in the Mayo Clinic SCAD Registry (MCSR) to gain insight into the association of SCAD and atrial arrhythmias. Methods: Atrial arrhythmias were queried amongst patients in the MCSR using diagnostic codes and text contained in both a large data repository known as the Advanced Cohort Explorer as well as a clinical database maintained by nurse abstractors for patients in the MCSR. All positive were manually verified using available medical records. Univariable logistic regression analysis was performed using JMP to investigate associations with classic cardiovascular risk factors. Results: A total of 1,215 patients from the Mayo SCAD registry were included. Six patients had a pre SCAD atrial arrhythmia, 19 had an atrial arrhythmia during a SCAD event, and 11 had a post SCAD atrial arrhythmia. Univariable analysis did not reveal significant associations with diabetes, hypertension, hyperlipidemia, or smoking. Conclusion: Atrial arrhythmias were not uncommonly seen in patients at the time of or after SCAD, especially after cardiac arrest or coronary artery bypass grafting. No significant associations with traditional cardiovascular risk factors were observed. Further investigation into the mechanism of atrial arrhythmia development as well as its management in the setting of SCAD is warranted.

scholarly journals Incidence of and risk factors for postoperative delirium in older adult patients undergoing noncardiac surgery: a prospective study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Arissara Iamaroon ◽  
Titima Wongviriyawong ◽  
Patumporn Sura-arunsumrit ◽  
Nattikan Wiwatnodom ◽  
Nichakarn Rewuri ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Older Adult ◽  
Postoperative Delirium ◽  
Noncardiac Surgery ◽  
Adult Patients ◽  
A Prospective Study

scholarly journals 38 Identifying predictive risk factors for permanent pacemaker implantation up to 30 days post-TAVI

2021 ◽  
Author(s):  
Jiaqi Li ◽  
Annita Christodoulidou ◽  
James Cranley ◽  
Farhana Ara ◽  
Charis Costopoulos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Permanent Pacemaker Implantation ◽  
Predictive Risk

scholarly journals Prevalence and determinants of diabetes and prediabetes in southwestern Iran: the Khuzestan comprehensive health study (KCHS)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanam Hariri ◽  
Zahra Rahimi ◽  
Nahid Hashemi-Madani ◽  
Seyyed Ali Mard ◽  
Farnaz Hashemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Waist Circumference ◽  
Multinomial Logistic Regression ◽  
Fasting Blood Glucose ◽  
Health Study ◽  
Khuzestan Province ◽  
Logistic Regression Models ◽  
Relative Risks ◽  
Southwestern Iran

Background The Middle East and North Africa (MENA) is postulated to have the highest increase in the prevalence of diabetes by 2030; however, studies on the epidemiology of diabetes are rather limited across the region, including in Iran. Methods This study was conducted between 2016 and 2018 among Iranian adults aged 20 to 65 years residing in Khuzestan province, southwestern Iran. Diabetes was defined as the fasting blood glucose (FBG) level of 126 mg/dl or higher, and/or taking antidiabetic medications, and/or self-declared diabetes. Prediabetes was defined as FBG 100 to 125 mg/dl. Multinomial logistic regression models were used to examine the association of multiple risk factors that attained significance on the outcome. Results Overall, 30,498 participants were recruited; the mean (±SD) age was 41.6 (±11.9) years. The prevalence of prediabetes and diabetes were 30.8 and 15.3%, respectively. We found a similar prevalence of diabetes in both sexes, although it was higher among illiterates, urban residents, married people, and smokers. Participants aged 50–65 and those with Body Mass Index (BMI) 30 kg/m2 or higher were more likely to be affected by diabetes [RR: 20.5 (18.1,23.3) and 3.2 (3.0,3.6)]. Hypertension [RR: 5.1 (4.7,5.5)], waist circumference (WC) equal or more than 90 cm [RR: 3.6 (3.3,3.9)], and family history [RR: 2.3 (2.2,2.5)] were also significantly associated with diabetes. For prediabetes, the main risk factors were age 50 to 65 years [RR: 2.6 (2.4,2.8)], BMI 30 kg/m2 or higher [RR: 1.9 (1.8,2.0)], hypertension and WC of 90 cm or higher [RR: 1.7 (1.6,1.8)]. The adjusted relative risks for all variables were higher in females than males, with the exception of family history for both conditions and waist circumference for prediabetes. Conclusions Prediabetes and diabetes are prevalent in southwestern Iran. The major determinants are older age, obesity, and the presence of hypertension. Further interventions are required to escalate diabetes prevention and diagnosis in high-risk areas across Iran.

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