Congenital heart diseaseCohort study
Incidence, Risk Factors, and Outcomes of Atrial Arrhythmias in Patients With Ebstein Anomaly
- retrospective observational study
- large tertiary referral center
Authors' conclusion
The lifetime burden of arrhythmic events in patients with EA is considerable, with more than half developing atrial arrhythmias by the age of 60 years. Intra-atrial re-entrant tachycardia/focal atrial tachycardia is the predominant arrhythmia, although the cumulative incidence of atrial fibrillation is also substantial. The significantly higher incidence of atrial arrhythmia observed in patients who underwent cardiac surgery is driven by a more advanced disease severity.
Study context
- Population
- Patients diagnosed with Ebstein anomaly (EA) between 2001 and 2024patients with EA (55.5% women, mean age at the last follow-up: 40.4 ± 17.8 years)
- Participants
- 200 patients
- Exposure
- patients who underwent at least 1 cardiac surgery vs nonoperated patients
Main finding
As reported in the abstract
Any atrial arrhythmia
79 (39.5%)
Focal atrial tachycardia/intra-atrial re-entrant tachycardia
54 (27.0%)
Atrial fibrillation
37 (18.5%)
Both arrhythmias
12 (6.0%)
Observational data: associations, not effects.
Further findings
| Outcome | patients who underwent at least 1 cardiac surgery | nonoperated patients | Estimate | P value | |
|---|---|---|---|---|---|
| Risk factors independently associated with atrial arrhythmias — Cardiac surgery vs nonoperated patients · Time-dependent Cox regression models | HR 3.10 (95% CI 1.80–5.32) | ||||
| Risk factors independently associated with atrial arrhythmias — moderate-to-severe tricuspid regurgitation vs nonoperated patients · Time-dependent Cox regression models | HR 2.44 (95% CI 1.47–4.06) | ||||
| Risk factors independently associated with atrial arrhythmias — severe right ventricular dysfunction vs nonoperated patients · Time-dependent Cox regression models | HR 2.40 (95% CI 1.21–4.78) | ||||
| Risk factors independently associated with atrial arrhythmias — age vs nonoperated patients · Time-dependent Cox regression models | HR 1.18 by 5-year increment (95% CI 1.09–1.28) | ||||
| Atrial arrhythmia by cardiac surgery | 46.2% | 21.8% | HR 3.10 (95% CI 1.80–5.32) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Estimated lifetime risk of atrial arrhythmia · ages 20, 40, and 60 years
- Age 20 years
- 5.7% (2.3%-9.0%)
- Age 40 years
- 25.0% (18.1%-31.9%)
- Age 60 years
- 54.2% (44.1%-64.3%)
Original publication
Summarised from the published abstract; every number is checked against it