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  • Open Access

    ARTICLE

    The incidence of arrhythmias during exercise stress tests among children with Kawasaki disease: A single-center case series

    Varun Aggarwal1,2, Kristen Sexson-Tejtal1, Wilson Lam1, Santiago O. Valdes1, Caridad M. de la Uz1, Jeffrey J. Kim1, Christina Y. Miyake1

    Congenital Heart Disease, Vol.14, No.6, pp. 1032-1036, 2019, DOI:10.1111/chd.12864

    Abstract Objective: Based on 2017 guidelines, participation in competitive sports with prior history of Kawasaki Disease (KD) requires those with coronary artery aneurysms (CAA) z score ≥ 5 to undergo evaluation for evidence of inducible ischemia or arrhythmias. The use of exercise stress testing (EST) to evaluate arrhythmias among KD patients has never been reported. This retrospective single-center case series study sought to describe the presence of inducible arrhythmias during EST in KD patients with or without CAA.
    Methods: Single-center retrospective review of medical records of patients diagnosed with KD between 1989-2015 at Texas Children’s Hospital, Houston, Texas who underwent EST… More >

  • Open Access

    ARTICLE

    Atrial fibrillation in adults with congenital heart disease following cardiac surgery in a single center: Analysis of incidence and risk factors

    Michael A. Brock, John‐Anthony Coppola, Jana Reid, Diego Moguillansky

    Congenital Heart Disease, Vol.14, No.6, pp. 924-930, 2019, DOI:10.1111/chd.12857

    Abstract Objective: The primary aim of our work is to determine the incidence of atrial fibrillation following cardiac surgery in adults with congenital heart disease. Secondary aims include identifying risk factors predictive of developing early postoperative atrial fibrillation and morbidities associated with early postoperative atrial fibrillation.
    Design: Retrospective analysis.
    Setting: Single center, quaternary care children’s hospital.
    Patients: This review included patients at least 18 years of age with known congenital heart disease who underwent cardiac surgery requiring a median sternotomy at our congenital heart center from January 1, 2012 to December 31, 2016.
    Interventions: None.
    Outcome Measures: The primary outcome was… More >

  • Open Access

    ARTICLE

    Improvement in ventricular function with rhythm control of atrial arrhythmias may delay the need for atrioventricular valve surgery in adults with congenital heart disease

    Benjamin Zielonka1, Yuli Y. Kim2,3, Gregory E. Supple2, Sara L. Partington2,3, Emily S. Ruckdeschel2,3, Francis E. Marchlinski2, David S. Frankel2

    Congenital Heart Disease, Vol.14, No.6, pp. 931-938, 2019, DOI:10.1111/chd.12833

    Abstract Objective: Atrial arrhythmias and atrioventricular valve regurgitation (AVVR) are common causes of morbidity among adults with congenital heart disease (ACHD). The impact of rhythm control on AVVR in this population is unknown. We sought to determine whether a rhythm control strategy is associated with greater freedom from AV valve surgery than a rate control strategy.
    Design: Patients evaluated by both ACHD and electrophysiology specialists at a single academic center were screened for atrial arrhythmias and at least moderate‐severe AVVR. Clinical and electrographic data were abstracted. All echocardiograms were in‐ terpreted by a single echocardiographer blinded to treatment strategy. Patients were… More >

  • Open Access

    ARTICLE

    Postoperative and short‐term atrial tachyarrhythmia burdens after transcatheter vs surgical pulmonary valve replacement among congenital heart disease patients

    Subeer K. Wadia1, Gentian Lluri1, Jamil A. Aboulhosn1, Hillel Laks2, Reshma M. Biniwale2, Glen S. Van Arsdell2, Daniel S. Levi3, Morris M. Salem3, Kevin M. Shannon1,3, Jeremy P. Moore1,3

    Congenital Heart Disease, Vol.14, No.5, pp. 838-845, 2019, DOI:10.1111/chd.12818

    Abstract Objective: We examined the atrial tachyarrhythmia (AT) burden among patients with congenital heart disease (CHD) following transcatheter (TC‐) or surgical (S‐) pulmo‐ nary valve replacement (PVR).
    Design/Setting: This was a retrospective observational study of patients who under‐ went PVR from 2010 to 2016 at UCLA Medical Center.
    Patients: Patients of all ages who had prior surgical repair for CHD were included. Patients with a history of congenitally corrected transposition of the great arteries, underwent a hybrid PVR procedure, or had permanent atrial fibrillation (AF) without a concomitant ablation were excluded.
    Outcome Measures: The primary outcome was a time‐to‐event analysis of… More >

  • Open Access

    ARTICLE

    Detection of arrhythmias in adult congenital heart disease patients with LINQTM implantable loop recorder

    Anudeep K. Dodeja1, Courtney Thomas1, Curt J. Daniels1,2, Naomi Kertesz1,2, Anna Kamp1,2

    Congenital Heart Disease, Vol.14, No.5, pp. 745-751, 2019, DOI:10.1111/chd.12815

    Abstract Background: Rhythm disorders are the leading cause of morbidity and mortality in adults with congenital heart disease (ACHD). Infrequent or asymptomatic arrhyth‐ mias may not be detected by routine monitoring. Implantable loop recorders (ILRs), such as the Reveal LINQTM, have been useful in long‐term monitoring for arrhythmias in adults with cryptogenic stroke.
    Objective: We propose the Reveal LINQTM will detect arrhythmias, not documented by other monitoring modalities, resulting in change in management in ACHD patients.
    Methods: This is a single center retrospective review of Reveal LINQTM use in ACHD patients from 2014‐2017. Medical records were reviewed to determine cardiac diag‐… More >

  • Open Access

    ARTICLE

    Extended cardiac ambulatory rhythm monitoring in adults with congenital heart disease: Arrhythmia detection and impact of extended monitoring

    Karen E. Schultz1, George K. Lui1,2, Doff B. McElhinney1, Jin Long3, Vidhya Balasubramanian3, Charlotte Sakarovitch3, Susan M. Fernandes1,2, Anne M. Dubin1, Ian S. Rogers1,2, Anitra W. Romfh1,2, Kara S. Motonaga1, Mohan N. Viswanathan2, Scott R. Ceresnak1

    Congenital Heart Disease, Vol.14, No.3, pp. 410-418, 2019, DOI:10.1111/chd.12736

    Abstract Background: Arrhythmias are a leading cause of death in adults with congenital heart disease (ACHD). While 24‐48‐hour monitors are often used to assess arrhythmia burden, extended continuous ambulatory rhythm monitors (ECAM) can record 2 weeks of data. The utility of this device and the arrhythmia burden identified beyond 48‐hour monitoring have not been evaluated in the ACHD population. Additionally, the impact of ECAM has not been studied to determine management recommendations.
    Objective: To address the preliminary question, we hypothesized that clinically sig‐ nificant arrhythmias would be detected on ECAM beyond 48 hours and this would lead to clinical management changes.
    More >

  • Open Access

    ARTICLE

    Dysrhythmias in patients with a complete atrioventricular septal defect: From surgery to early adulthood

    Charlotte A. Houck1,2, Reinder Evertz3, Christophe P. Teuwen1, Jolien W. Roos‐Hesselink1, Janneke A. E. Kammeraad4, Anthonie L. Duijnhouwer3, Natasja M. S. de Groot3, Ad J. J. C. Bogers2

    Congenital Heart Disease, Vol.14, No.2, pp. 280-287, 2019, DOI:10.1111/chd.12724

    Abstract Objective: Outcomes after surgical repair of complete atrioventricular septal defect (cAVSD) have improved. With advancing age, the risk of development of dysrhythmias may increase. The aims of this study were to (1) examine development of sinus node dysfunction (SND), atrial and ventricular tachyarrhythmias, and (2) study progression of atrioventricular conduction abnormalities in young adult patients with repaired cAVSD.
    Study design: In this retrospective multicenter study, 74 patients (68% female) with a cAVSD repaired in childhood were included. Patients’ medical files were evaluated for occurrence of SND, atrioventricular conduction block (AVB), atrial and ventricular tachyarrhythmias.
    Results: Median age at repair was… More >

  • Open Access

    ARTICLE

    Predictors and rates of recurrence of atrial arrhythmias following catheter ablation in adults with congenital heart disease

    Matthew Lewis1, William Whang2, Angelo Biviano2, Kathleen Hickey2, Hasan Garan2, Marlon Rosenbaum1

    Congenital Heart Disease, Vol.14, No.2, pp. 207-212, 2019, DOI:10.1111/chd.12695

    Abstract Background: Catheter ablation is commonly performed to treat atrial arrhythmias in adult congenital heart disease (ACHD). Despite the frequency of ablations in the ACHD population, predictors of recurrence remain poorly defined.
    Objective: We sought to determine predictors of arrhythmia recurrence in ACHD patients following catheter ablation for atrial arrhythmias.
    Methods: We performed a retrospective study of all catheter ablations for atrial arrhythmias performed in ACHD patients between January 12, 2005 and February 11, 2015 at our institution. Prespecified exposures of interest and time from ablation to recurrence were determined via chart review.
    Results: Among 124 patients (mean age: 45 years)… More >

  • Open Access

    ARTICLE

    Electrocardiographic early repolarization characteristics and clinical presentations in the young: a benign finding or worrisome marker for arrhythmias

    Raya Safa, Ronald Thomas, Peter P. Karpawich

    Congenital Heart Disease, Vol.12, No.1, pp. 99-104, 2017

    Abstract Background: The early ECG repolarization QRS pattern (ERp), with J-point elevation of 0.1 mV in two contiguous inferior and/or lateral leads, can be associated with ventricular arrhythmias among adults. The significance of an ERp in the young is unknown.
    Objective: The purpose of this study was to assess the prevalence of ERp among young patients (pts), describe and correlate the characteristics with clinical presentations and any arrhythmias.
    Methods: This was a 1 y retrospective review of ECGs obtained from patients referred specifically for documented arrhythmias, possible arrhythmia-related symptoms or sports clearance. ECGs were analyzed for ERp (J-point, ascending/horizontal patterns, location)… More >

  • Open Access

    ARTICLE

    Late gadolinium enhancement and adverse outcomes in a contemporary cohort of adult survivors of tetralogy of Fallot

    Richard J. Dobson1, Ify Mordi2, Mark H. Danton1, Niki L. Walker1, Hamish A. Walker1, Nikolaos Tzemos2

    Congenital Heart Disease, Vol.12, No.1, pp. 58-66, 2017

    Abstract Objective: Myocardial fibrosis has been associated with poorer outcomes in tetralogy of Fallot, however only a handful of studies have assessed its significance in the current era. Our aim was to quantify the amount of late gadolinium enhancement in both the LV and RV in a contemporary cohort of adults with surgically repaired tetralogy of Fallot, and assess the relationship with adverse clinical outcomes.
    Design: Single centre cohort study
    Setting: National tertiary referral center
    Patients: One hundred fourteen patients with surgically repaired tetralogy of Fallot with median age 29.5 years (range 17.5-64.2). Prospective follow-up for mean 2.4 years (SD 1.29).
    More >

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