Interactive cardiovascular and thoracic surgery · 2018
Concomitant arrhythmia surgery in patients with congenital heart disease.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ramdjan Tanwier T T K, Mouws Elisabeth M J P, Kik Charles, Roos-Hesselink Jolien W, Bogers Ad J J C, de Groot Natasja M S
Аннотация
OBJECTIVES: Atrial tachyarrhythmia, including atrial fibrillation (AF), atrial flutter (AFL) and intra-atrial reentrant tachycardia (IART), occur frequently in patients with congenital heart disease (CHD), who may undergo multiple surgical procedures throughout life. However, data on the effectiveness of concomitant arrhythmia surgery in CHD patients are scarce.
METHODS: Outcome of concomitant arrhythmia surgery for AF or AFL/IART was examined in 66 successive patients [31 men (47%); age at surgery: 56 ± 14 (24-78) years] with various CHD.
RESULTS: Concomitant arrhythmia surgery was performed in patients with a history of only AF (n = 46, 70%), only AFL/IART (n = 6, 9%) or a combination of AF and AFL/IART (n = 14, 21%). Median follow-up after arrhythmia surgery was 2 (1-4) years. AF reoccurred in 40 patients (67%), of whom 13 (22%) only had early recurrences; none of the patients with only AFL or IART prior to arrhythmia surgery developed AF after arrhythmia surgery. Recurrence-free survival of late AF was 4.6 years and differed according to the type of AF prior to surgery. Late recurrence-free survival at 3-year follow-up was 71% for paroxysmal AF, 45% for persistent AF and 20% for long-standing persistent AF (P = 0.047). Age at arrhythmia surgery was an independent predictor for late AF recurrence (odds ratio 1.05, P = 0.006). AFL/IART occurred in 17 patients (26%) after arrhythmia surgery, which was de novo in 11 patients (17%).
CONCLUSIONS: Arrhythmia surgery in CHD patients results in freedom from late AF recurrence for a small majority of patients after median follow-up of 2 years. (Long-standing) persistent AF and older age at arrhythmia surgery are related to higher recurrence rates.
METHODS: Outcome of concomitant arrhythmia surgery for AF or AFL/IART was examined in 66 successive patients [31 men (47%); age at surgery: 56 ± 14 (24-78) years] with various CHD.
RESULTS: Concomitant arrhythmia surgery was performed in patients with a history of only AF (n = 46, 70%), only AFL/IART (n = 6, 9%) or a combination of AF and AFL/IART (n = 14, 21%). Median follow-up after arrhythmia surgery was 2 (1-4) years. AF reoccurred in 40 patients (67%), of whom 13 (22%) only had early recurrences; none of the patients with only AFL or IART prior to arrhythmia surgery developed AF after arrhythmia surgery. Recurrence-free survival of late AF was 4.6 years and differed according to the type of AF prior to surgery. Late recurrence-free survival at 3-year follow-up was 71% for paroxysmal AF, 45% for persistent AF and 20% for long-standing persistent AF (P = 0.047). Age at arrhythmia surgery was an independent predictor for late AF recurrence (odds ratio 1.05, P = 0.006). AFL/IART occurred in 17 patients (26%) after arrhythmia surgery, which was de novo in 11 patients (17%).
CONCLUSIONS: Arrhythmia surgery in CHD patients results in freedom from late AF recurrence for a small majority of patients after median follow-up of 2 years. (Long-standing) persistent AF and older age at arrhythmia surgery are related to higher recurrence rates.