A study published in the Circulation journal has shown that the risk of atrial fibrillation (AF) in young adults and children who suffer from congenital heart disease (CHD) was 22 times higher than in a matched control group.
The study by Zacharias Mandalenakis et al used data from the Swedish Patient and Cause of Death Registers to identify 21,982 patients (51.6% men) with a diagnosis of CHD who were born between 1970 and 1993. The control group of 219,816 was matched by birth year, sex and county from the Total Population Register in Sweden, with 10 controls to every CHD patient.
Follow-up data were collected until 2011, with a mean of 27 years. Mandalenakis et al found that by 2011, 654 CHD patients had developed AF, compared to 328 people from the control group. For the former group, the risk of developing AF was 21.99 times higher (95% confidence interval, 19.26-25.12).
At the age of 42 years, 8.3% of all patients with CHD had been diagnosed with AF, and 10.7% (70/654) of patients with both diagnoses experienced heart failure.
Among CHD patients, the patients with the highest risk of AF were those with complex congenital defects, particularly conotruncal defects (hazard ration, 84.27; 95% confidence intercal, 56.86-124.89). Mandalenakis et al suggested this subset could be considered for targeted monitoring.
Increasing prevalence of AF and permanent atrial arrhythmias in congenital heart disease
A recent multicentre retrospective cohort study by Fabien Labombarda et al assessed the types of atrial arrhythmias associated with CHD. The study was published earlier this year in the Journal of the American College of Cardiology.
In a cohort of 482 patients with CHD and atrial arrhythmias (age 32.0 ± 18.0 years; 45.2% female), AF was shown to be the second most common arrhythmia at 28.8%. In fact a significant majority (61.6%) of the patient population presented with intra-atrial re-entrant tachycardia (IART). However, the study found that as the population ages, AF increases in prevalence and atrial arrhythmias progressively become permanent.