Arrhythmia Surgery in Patients With and Without Congenital Heart Disease

Constantine Mavroudis*, Barbara Deal, Carl L Backer, Sabrina Tsao

*Corresponding author for this work

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Background: Arrhythmia surgery has favorably impacted the clinical course of debilitating atrial and ventricular arrhythmias in patients with and without congenital heart disease. This study reviews arrhythmia mechanisms and documents long-term outcome of patients undergoing arrhythmia operations alone or associated with congenital heart repairs. The analysis excludes Fontan conversion patients. Methods: Between 1987 and 2007, arrhythmia operations were done in 11 patients without associated congenital heart disease and in 89 along with congenital heart repairs. Mean age was 15.9 ± 12.5 years (range, 7 days-48 years); 7 were infants (mean age, 23 ± 16 days). Resternotomy was performed in 65 (65%). Two functional ventricles were present in 67 patients; 33 had 1 functional ventricle. Arrhythmias included macro-reentrant atrial tachycardia in 45, atrial fibrillation in 11, accessory connections in 19, atrioventricular nodal reentry tachycardia in 6, focal atrial tachycardia in 6, and ventricular tachycardia in 13. Results: Operative mortality was 3 (3.0%) due to advanced associated congenital heart disease. There were 4 late deaths (4.0%) and 2 late cardiac transplants (2.0%). Freedom from arrhythmia recurrence at 1 and 10 years was 94% and 85% for atrial arrhythmias, and 85% and 68% for ventricular arrhythmias, respectively. Conclusions: Successful surgical therapy for atrial arrhythmias can be performed safely with a high freedom from recurrence rate in patients with and without associated congenital heart disease. Surgical ablation for ventricular arrhythmias is less predictive. Complexity of the underlying congenital heart disease and hemodynamic status may contribute to potential arrhythmia recurrence or new onset arrhythmia manifestation.

Original languageEnglish (US)
Pages (from-to)857-868
Number of pages12
JournalAnnals of Thoracic Surgery
Volume86
Issue number3
DOIs
StatePublished - Sep 1 2008

Fingerprint

Cardiac Arrhythmias
Heart Diseases
Tachycardia
Recurrence
Atrioventricular Nodal Reentry Tachycardia
Ventricular Tachycardia
Atrial Fibrillation
Hemodynamics
Transplants
Mortality

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

@article{78d8d97909eb410cbd2d8720fbbdd009,
title = "Arrhythmia Surgery in Patients With and Without Congenital Heart Disease",
abstract = "Background: Arrhythmia surgery has favorably impacted the clinical course of debilitating atrial and ventricular arrhythmias in patients with and without congenital heart disease. This study reviews arrhythmia mechanisms and documents long-term outcome of patients undergoing arrhythmia operations alone or associated with congenital heart repairs. The analysis excludes Fontan conversion patients. Methods: Between 1987 and 2007, arrhythmia operations were done in 11 patients without associated congenital heart disease and in 89 along with congenital heart repairs. Mean age was 15.9 ± 12.5 years (range, 7 days-48 years); 7 were infants (mean age, 23 ± 16 days). Resternotomy was performed in 65 (65{\%}). Two functional ventricles were present in 67 patients; 33 had 1 functional ventricle. Arrhythmias included macro-reentrant atrial tachycardia in 45, atrial fibrillation in 11, accessory connections in 19, atrioventricular nodal reentry tachycardia in 6, focal atrial tachycardia in 6, and ventricular tachycardia in 13. Results: Operative mortality was 3 (3.0{\%}) due to advanced associated congenital heart disease. There were 4 late deaths (4.0{\%}) and 2 late cardiac transplants (2.0{\%}). Freedom from arrhythmia recurrence at 1 and 10 years was 94{\%} and 85{\%} for atrial arrhythmias, and 85{\%} and 68{\%} for ventricular arrhythmias, respectively. Conclusions: Successful surgical therapy for atrial arrhythmias can be performed safely with a high freedom from recurrence rate in patients with and without associated congenital heart disease. Surgical ablation for ventricular arrhythmias is less predictive. Complexity of the underlying congenital heart disease and hemodynamic status may contribute to potential arrhythmia recurrence or new onset arrhythmia manifestation.",
author = "Constantine Mavroudis and Barbara Deal and Backer, {Carl L} and Sabrina Tsao",
year = "2008",
month = "9",
day = "1",
doi = "10.1016/j.athoracsur.2008.04.087",
language = "English (US)",
volume = "86",
pages = "857--868",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "3",

}

Arrhythmia Surgery in Patients With and Without Congenital Heart Disease. / Mavroudis, Constantine; Deal, Barbara; Backer, Carl L; Tsao, Sabrina.

In: Annals of Thoracic Surgery, Vol. 86, No. 3, 01.09.2008, p. 857-868.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Arrhythmia Surgery in Patients With and Without Congenital Heart Disease

AU - Mavroudis, Constantine

AU - Deal, Barbara

AU - Backer, Carl L

AU - Tsao, Sabrina

PY - 2008/9/1

Y1 - 2008/9/1

N2 - Background: Arrhythmia surgery has favorably impacted the clinical course of debilitating atrial and ventricular arrhythmias in patients with and without congenital heart disease. This study reviews arrhythmia mechanisms and documents long-term outcome of patients undergoing arrhythmia operations alone or associated with congenital heart repairs. The analysis excludes Fontan conversion patients. Methods: Between 1987 and 2007, arrhythmia operations were done in 11 patients without associated congenital heart disease and in 89 along with congenital heart repairs. Mean age was 15.9 ± 12.5 years (range, 7 days-48 years); 7 were infants (mean age, 23 ± 16 days). Resternotomy was performed in 65 (65%). Two functional ventricles were present in 67 patients; 33 had 1 functional ventricle. Arrhythmias included macro-reentrant atrial tachycardia in 45, atrial fibrillation in 11, accessory connections in 19, atrioventricular nodal reentry tachycardia in 6, focal atrial tachycardia in 6, and ventricular tachycardia in 13. Results: Operative mortality was 3 (3.0%) due to advanced associated congenital heart disease. There were 4 late deaths (4.0%) and 2 late cardiac transplants (2.0%). Freedom from arrhythmia recurrence at 1 and 10 years was 94% and 85% for atrial arrhythmias, and 85% and 68% for ventricular arrhythmias, respectively. Conclusions: Successful surgical therapy for atrial arrhythmias can be performed safely with a high freedom from recurrence rate in patients with and without associated congenital heart disease. Surgical ablation for ventricular arrhythmias is less predictive. Complexity of the underlying congenital heart disease and hemodynamic status may contribute to potential arrhythmia recurrence or new onset arrhythmia manifestation.

AB - Background: Arrhythmia surgery has favorably impacted the clinical course of debilitating atrial and ventricular arrhythmias in patients with and without congenital heart disease. This study reviews arrhythmia mechanisms and documents long-term outcome of patients undergoing arrhythmia operations alone or associated with congenital heart repairs. The analysis excludes Fontan conversion patients. Methods: Between 1987 and 2007, arrhythmia operations were done in 11 patients without associated congenital heart disease and in 89 along with congenital heart repairs. Mean age was 15.9 ± 12.5 years (range, 7 days-48 years); 7 were infants (mean age, 23 ± 16 days). Resternotomy was performed in 65 (65%). Two functional ventricles were present in 67 patients; 33 had 1 functional ventricle. Arrhythmias included macro-reentrant atrial tachycardia in 45, atrial fibrillation in 11, accessory connections in 19, atrioventricular nodal reentry tachycardia in 6, focal atrial tachycardia in 6, and ventricular tachycardia in 13. Results: Operative mortality was 3 (3.0%) due to advanced associated congenital heart disease. There were 4 late deaths (4.0%) and 2 late cardiac transplants (2.0%). Freedom from arrhythmia recurrence at 1 and 10 years was 94% and 85% for atrial arrhythmias, and 85% and 68% for ventricular arrhythmias, respectively. Conclusions: Successful surgical therapy for atrial arrhythmias can be performed safely with a high freedom from recurrence rate in patients with and without associated congenital heart disease. Surgical ablation for ventricular arrhythmias is less predictive. Complexity of the underlying congenital heart disease and hemodynamic status may contribute to potential arrhythmia recurrence or new onset arrhythmia manifestation.

UR - http://www.scopus.com/inward/record.url?scp=49549121417&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=49549121417&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2008.04.087

DO - 10.1016/j.athoracsur.2008.04.087

M3 - Article

C2 - 18721574

AN - SCOPUS:49549121417

VL - 86

SP - 857

EP - 868

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 3

ER -