Outcomes After Development of Ventricular Arrhythmias in Single Ventricular Heart Disease Patients With Fontan Palliation
Main finding · Transplant or deathResult — go to the resultHazard ratio 9.2 95% CI 4.5–18.7Authors' conclusion
Ventricular arrhythmias occurred in 11% of Fontan patients and was highly associated with transplant or death, with a transplant-free survival of <50% at 5-year post-VA diagnosis.
Study context
- Population
- Single ventricle patients with Fontan palliation seen at a single center, 2002–2019, without preFontan VA
- Participants
- 431 patients
- Exposure
- Post-Fontan VA vs no VA
- VAn = 48
- Outcome
- Death and heart transplantation
Methodological detailssingle-centre
- Single-centre
Main finding
Transplant or death
Hazard ratio
9.2
95% CI 4.5–18.7
P < 0.001
By group
VA
48%
Transplant-free survival at 5 years post-VA diagnosis
VAvs No VA
HR 9.2 (95% CI 4.5–18.7); P < 0.001
As reported in the abstract
- Overall primary outcome (death or transplant)
- 64 (15%)
- Overall transplant-free survival at 15 years post-Fontan
- 82%
- Death
- 16, 3.7%
- Transplant
- 48, 11%
Observational data: associations, not effects.
Secondary outcomes
Incidence of VA
- VA diagnosed
- 48 (11%)
- Nonsustained VT among VA
- 90%
- Sustained VT among VA
- 10%
- Malignant VA
- 9, 2.0%
- VA risk at 10 years
- 2.4%
- VA risk at 20 years
- 19%
Risk factors for VA
- Stage 1 surgery with RV to pulmonary artery conduit and older age at Fontan were significant risk factors for VA
Malignant VA associations
- Malignant VA associated with younger age, worse systolic function and valvular regurgitation
Original publication
Outcomes After Development of Ventricular Arrhythmias in Single Ventricular Heart Disease Patients With Fontan Palliation. Circ Arrhythm Electrophysiol. Published 31 May 2023. doi:10.
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