Patterns of Incidence Rates of Cardiac Complications in Patients With Congenital Heart Disease.

Arslani, Ketina; Roffler, Nico; Zurek, Marzena; Greutmann, Matthias; Schwerzmann, Markus; Bouchardy, Judith; Rutz, Tobias; Ehl, Niklas F; Jost, Christine Attenhofer; Tobler, Daniel (2018). Patterns of Incidence Rates of Cardiac Complications in Patients With Congenital Heart Disease. Canadian journal of cardiology, 34(12), pp. 1624-1630. Canadian Cardiology Publications 10.1016/j.cjca.2018.09.010

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BACKGROUND This study aimed to evaluate age at the first onset of cardiac complications and variation of frequency of complications between different congenital heart defects. METHODS The analysis included participants of the Swiss Adult Congenital Heart Disease Registry (SACHER). For this study, cardiac complications up to the time of inclusion in SACHER were analysed. Complications included atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular tachycardia, complete heart block, heart failure, stroke, endocarditis, myocardial infarction, and pulmonary hypertension. Incidence rates (IR; incidence rate per 1000 patient-years) for different age categories and diagnosis groups were analysed. RESULTS Of 2731 patients (55% male, mean age 34 ± 14 years, 92,349 patient-years), a total of 767 (28%) had experienced at least 1 cardiac complication. The majority of complications (550; 72%) occurred in adulthood (> 18 years). Apart from perioperative stroke (IR: 1.77 in age group ≤ 4 years) and complete heart block (IR: 2.36 in age group ≤ 4 years), IR were much lower in childhood (IR < 1 for all complications between 5 and 17 years). Incidence of cardiac complications increased during adult life with highest IR for atrial fibrillation and atrial flutter in the age group ≥ 50 years (IR: 17.6 and 9.7, respectively). There were important variations of the distribution of complications among different diagnosis groups. CONCLUSIONS Cardiac complications are frequent in congenital heart disease. Apart from perioperative stroke and complete heart block, IR are low in childhood but the incidence increases during adult life. These data underscore the need of lifelong follow-up and may help for better allocation of resources maintaining follow-up.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Schwerzmann, Markus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0828-282X

Publisher:

Canadian Cardiology Publications

Language:

English

Submitter:

Markus Schwerzmann

Date Deposited:

24 Jan 2019 16:02

Last Modified:

05 Dec 2019 08:52

Publisher DOI:

10.1016/j.cjca.2018.09.010

PubMed ID:

30527151

BORIS DOI:

10.7892/boris.122676

URI:

https://boris.unibe.ch/id/eprint/122676

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