Arrhythmias tied to poorer survival in adults with congenital heart disease
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Key takeaways:
- Adults with congenital heart disease may have increased risk for hospitalization if they also develop an arrhythmia.
- Certain arrhythmias may also confer an up to twofold increase in mortality risk.
Arrhythmia disorders in patients with adult congenital heart disease may significantly contribute to hospitalization and mortality risk, according to data published in the Journal of the American Heart Association.
“Our findings highlight the need for ongoing, lifelong, clinical follow-up for people with congenital heart disease,” Nili Schamroth-Pravda, MBBCh, cardiologist at the Rabin Medical Center in Petah Tikva, Israel, said in a press release. “With the improvement of medical and surgical techniques, the number of patients with congenital heart disease reaching adulthood is increasing, as well as the complications associated with these heart conditions.
“The health care system should be aware of the unfavorable effects of arrhythmias in this increasing population and the consequent increase in both primary care visits and hospitalizations,” Schamroth-Pravda said.
To better understand prevalence of arrhythmias, risk factors and associated health care use in patients with adult congenital heart disease, Schamroth-Pravda and colleagues evaluated electronic health record data from 11,653 patients insured by Clalit and Maccabi national health frameworks in Israel from 2007 to 2011 (median age, 47 years).
All patients in the cohort had at least one documented congenital heart lesion or congenital heart malformation repair procedure and were followed for 5 years.
At baseline, 8.7% of the cohort had tachyarrhythmia, 1.5% had a conduction disturbance and 0.5% had both.
Among patients with no arrhythmia at baseline, 9.2% developed tachyarrhythmias, 0.9% developed a conduction disturbance and 0.3% developed both during the study period.
After multivariable adjustment, arrhythmia in the previous 6 months among individuals with adult congenital heart disease was associated with a higher hospitalization rate compared with no arrhythmia (RR with ventricular arrhythmia = 1.33; 95% CI, 1-1.76; RR with atrial arrhythmias = 1.27; 95% CI, 1.17-1.38; RR with atrioventricular block = 1.33; 95% CI, 1.04-1.71).
Moreover, atrial tachyarrhythmias (HR = 1.65; 95% CI, 1.44-2.94) and ventricular tachyarrhythmias (HR = 2.06; 95% CI, 1.44-2.94) were associated with increased mortality risk for patients with adult congenital heart disease.
“Our study suggests that the development of arrhythmias is a critical point in the life of adult patients with congenital heart disease and this has a profound impact on the health care system providing care for these patients,” Schamroth-Pravda said in the release.
Reference:
- Adults with congenital heart disease faced higher risk of abnormal heart rhythms. https://newsroom.heart.org/news/adults-with-congenital-heart-disease-faced-higher-risk-of-abnormal-heart-rhythms. Published April 17, 2024. Accessed April 17, 2024.
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