Clinical role of atrial arrhythmias in patients with arrhythmogenic right ventricular dysplasia


Autoria(s): Saguner, Ardan; Ganahl, Sabrina; Kraus, Andrea; Baldinger, Samuel Hannes; Medeiros Domingo, Argelia; Saguner, Arhan R; Mueller-Burri, Stephan; Wolber, Thomas; Haegeli, Laurent M; Nazmi, Krasniqi; Tanner, Felix C; Steffel, Jan; Brunckhorst, Corinna; Firat, Duru
Data(s)

20/10/2014

Resumo

BACKGROUND: The clinical role of atrial fibrillation/atrial flutter (AF-AFl) and variables predicting these arrhythmias are not well defined in patients with arrhythmogenic right ventricular dysplasia (ARVD). We hypothesized that transthoracic echocardiography (TTE) and 12-lead electrocardiography (ECG) would be helpful in predicting AF-AFl in these patients. METHODS AND RESULTS: ECGs and TTEs of 90 patients diagnosed with definite or borderline ARVD (2010 Task Force Criteria) were analyzed. Data were compared in (1) patients with AF-AFl and (2) all other patients. A total of 18 (20%) patients experienced AF-AFl during a median follow-up of 5.8 years (interquartile range 2.0-10.4). Kaplan-Meier analysis revealed reduced times to AF-AFl among patients with echocardiographic RV fractional area change <27% (P<0.001), left atrial diameter ≥24.4 mm/m(2)(parasternal long-axis, P=0.001), and right atrial short-axis diameter ≥22.1 mm/m(2)(apical 4-chamber view, P=0.05). From all ECG variables, P mitrale conferred the highest hazard ratio (3.37, 95% confidence interval 0.92-12.36, P=0.067). Five patients with AF-AFl experienced inappropriate implantable cardioverter-defibrillator (ICD) shocks compared with 4 without AF-AFl (36% vs. 9%, P=0.03). AF-AFl was more prevalent in heart-transplant patients and those who died of cardiac causes (56% vs. 16%, P=0.014). CONCLUSIONS: AF-AFl is associated with inappropriate ICD shocks, heart transplantation, and cardiac death in patients with ARVD. Evidence of reduced RV function and atrial dilation helps to identify the ARVD patients at increased risk for AF-AFl.

Formato

application/pdf

Identificador

http://boris.unibe.ch/63876/1/2014-%20Atrial%20arrhythmias.pdf

Saguner, Ardan; Ganahl, Sabrina; Kraus, Andrea; Baldinger, Samuel Hannes; Medeiros Domingo, Argelia; Saguner, Arhan R; Mueller-Burri, Stephan; Wolber, Thomas; Haegeli, Laurent M; Nazmi, Krasniqi; Tanner, Felix C; Steffel, Jan; Brunckhorst, Corinna; Firat, Duru (2014). Clinical role of atrial arrhythmias in patients with arrhythmogenic right ventricular dysplasia. Circulation journal, 78(12), pp. 2854-2861. Japanese Circulation Society 10.1253/circj.CJ-14-0474 <http://dx.doi.org/10.1253/circj.CJ-14-0474>

doi:10.7892/boris.63876

info:doi:10.1253/circj.CJ-14-0474

info:pmid:25327952

urn:issn:1346-9843

Idioma(s)

eng

Publicador

Japanese Circulation Society

Relação

http://boris.unibe.ch/63876/

Direitos

info:eu-repo/semantics/restrictedAccess

Fonte

Saguner, Ardan; Ganahl, Sabrina; Kraus, Andrea; Baldinger, Samuel Hannes; Medeiros Domingo, Argelia; Saguner, Arhan R; Mueller-Burri, Stephan; Wolber, Thomas; Haegeli, Laurent M; Nazmi, Krasniqi; Tanner, Felix C; Steffel, Jan; Brunckhorst, Corinna; Firat, Duru (2014). Clinical role of atrial arrhythmias in patients with arrhythmogenic right ventricular dysplasia. Circulation journal, 78(12), pp. 2854-2861. Japanese Circulation Society 10.1253/circj.CJ-14-0474 <http://dx.doi.org/10.1253/circj.CJ-14-0474>

Palavras-Chave #610 Medicine & health
Tipo

info:eu-repo/semantics/article

info:eu-repo/semantics/publishedVersion

PeerReviewed