Cohort study
Cardiac MRI Predictors of Arrhythmic Sudden Cardiac Events in Patients With Fontan Circulation
- Registry-based cohort study
- international registry
- multivariable Cox regression
Authors' conclusion
SCE occurred in 3.5% of the study population, and one-third of patients who experienced SCE died. Mild ventricular dysfunction and dilatation by cardiac magnetic resonance, NYHA functional class, and history of protein-losing enteropathy/plastic bronchitis were associated with SCE.
Study context
- Population
- Patients with Fontan circulation in the FORCE registry (CMR-based)41% female
- Participants
- 3,132 patients
- Outcome
- Prevalence of and risk factors for SCE (cardiac arrest from shockable rhythm, emergent cardioversion/defibrillation, or sustained VT)
- Follow-up
- Median 4.00 years
Main finding
As reported in the abstract
SCE
- Sudden cardiac events (SCE) prevalence
- 3.5% (n = 109)
- NYHA functional class >II, HR
- 4.91; P < 0.0001
- History of protein-losing enteropathy/plastic bronchitis, HR
- 2.37; P = 0.0082
- Single-ventricle end-diastolic volume index >104 mL/m², HR
- 3.15; P < 0.0001
- EF <50%, HR
- 1.73; P = 0.0437
Observational data: associations, not effects.
Further findings
Death among patients with SCE
- Died, of 109 with SCE
- 39 (36%)
4-year freedom from SCE with none of the risk factors (Kaplan-Meier)
- Freedom from SCE
- 99.5%
Original publication
Cardiac MRI Predictors of Arrhythmic Sudden Cardiac Events in Patients With Fontan Circulation. J Am Coll Cardiol. Published 23 October 2024. doi:10.1016/j.jacc.2024.08.063
Summarised from the published abstract; every number is checked against it