Twin atrioventricular nodes and accessory pathways in congenital heart diseases with abnormal atrioventricular connections: Association with the developmental hierarchy of cardiac morphology
Authors' conclusion
In CHD with abnormal AV connections, evidence suggested a developmental hierarchy in the propensity to exhibit TWAVNs, but not for accessory pathways. The earlier cardiac developmental errors occur, the higher the likelihood of TWAVNs and the greater the chance of SVT.
Study context
- Population
- CHD with abnormal atrioventricular (AV) connections and sufficient electrocardiographic (ECG) data for review, 1980–2022 cohort
- Participants
- 136 / 70 / 47 / 63
- Exposure
- Twin AV nodes and accessory pathways across CHD types with abnormal AV connections
- Heterotaxyn = 136
- Congenitally corrected transposition of the great arteries (ccTGA)n = 70
- Double-inlet ventricle (DIV)n = 47
- AV canaln = 63
- Outcome
- Presence of twin AV nodes (TWAVNs) and accessory pathways
Main finding
As reported in the abstract
TWAVNs
- TWAVNs detected in the same ECG
- 18%
- TWAVNs detected in separate ECGs
- 70.8%
- TWAVNs detected after electrophysiological study
- 11.2%
Observational data: associations, not effects.
Further findings
| Outcome | Heterotaxy | ccTGA | DIV | AV canal |
|---|---|---|---|---|
| Accessory pathways | 4.4% | 11.4% | 0 events | 0 events |
| Actuarial incidence of SVT · by age 10 | 0.354 | 0.121 | 0.022 | 0 |
Supraventricular tachycardia (SVT) risk in patients with TWAVNs, by TWAVN rate of CHD type
- TWAVN rate >50%
- 65.5%
- TWAVN rate 10%-50%
- 58.3%
- TWAVN rate <10%
- 0%
Onset age of tachycardia, TWAVNs vs accessory pathways
- Did not differ
Original publication
Twin atrioventricular nodes and accessory pathways in congenital heart diseases with abnormal atrioventricular connections: Association with the developmental hierarchy of cardiac morphology. Heart Rhythm. Published 6 November 2024. doi:10.
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