Arrhythmias in Patients with Congenital Heart Disease: a Modern View of the Problem

  • O. S. Stychynskyi National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
  • P. O. Almiz National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
  • A. V. Topchii National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
  • M. M. Petkanych National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
  • V. V. Lazoryshynets National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
Keywords: arrhythmias, congenital heart disease, recommendations, catheter destruction, arrhythmogenesis

Abstract

Thanks to the successes of modern cardiac surgery, more and more patients with congenital heart disease (CHD) reach adulthood, with approximately one in four having various heart rhythm disturbances. Their causes are both the CHD themselves and the consequences of surgical or interventional intervention. Arrhythmias in this category of patients worsen the quality of life, lead to serious complications, and can cause sudden cardiac death. The paper summarizes and analyzes current trends and recommendations of the world’s leading specialized communities for the management of patients with congenital heart disease with cardiac arrhythmias.

The article reflects approaches to the management and monitoring of this category of patients, including asymptomatic ones. The necessity of early detection of arrhythmia and the involvement of a team of specialists in specialized centers for the development of tactics and treatment after surgical correction is justified. Also discussed are the issues of indications for electrophysiological research and its feasibility, the possibility and effectiveness of catheter destruction, the need for continuous drug therapy, indications for implantation of artificial pacemakers and cardioverter-defibrillators. The paper also reflects the question of various mechanisms of the development of arrhythmia in patients after surgical correction of congenital heart defects, as well as highlighted the possible ways of preventing arrhythmogenesis in patients after surgical correction.

References

  1. Atallah J, Collins KK, Jonas RA, Mayer JE Jr, Triedman JK. Follow-up of a modified Fontan randomized trial for intraatrial reentrant tachycardia prophylaxis. Congenit. Heart Dis. 2012;7:219–25. https://doi.org/10.1111/j.1747-0803.2012.00636.x
  2. Calkins H, Hindriks G, Cappato R, et al. 2017 HRS/EH-RA/FCAS/APHRS/SOLAECE Expert consensus state-ment on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. 2017;14(10):e278–e243.
  3. Deal BJ, Costello JM, Webster G, Tsao S, Backer CL, Mavroudis C. Intermediate-term outcome of 140 Consecutive Fontan conversions with Arrhythmia operations. Ann. Thorac. Surg. 2016;101:717–24. https://doi.org/10.1016/j.athoracsur.2015.09.017
  4. Hernаˆndez-Madrid A, Paul T, Abrams D, Aziz PF, Blom NA, Chen J, et al. Arrhythmias in congenital heart disease: a position paper of the European Heart Rhythm Association (EHRA), Association for European Paediatric and Congenital Cardiology (AEPC), and the European Society of Cardiology (ESC) Working Group on Grown-up Congenital heart disease, endorsed by HRS, PACES, APHRS, and SOLAECE. Europace.2018;20(11):1719–53. https://doi.org/10.1093/europace/eux380
  5. Khairy P, Van Hare GF, Balaji S, Berul CI, Cecchin F, Cohen MI, et al. PACES/HRS Expert Consensus Statement on the Recognition and Management of Arrhythmias in Adult Congenital Heart Disease. Canadian Journal of Cardiology. 2014;30:e1–e63. https://doi.org/10.1016/j.cjca.2014.09.002
  6. Kusumoto FM, Schoenfeld MH, Barrett C, et al. 2018 ACC/AHA/HRS Guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay. Circulation. 2019 Aug 20;140(8):e382–e482.
Published
2020-01-07
How to Cite
Stychynskyi, O. S., Almiz, P. O., Topchii, A. V., Petkanych, M. M., & Lazoryshynets, V. V. (2019). Arrhythmias in Patients with Congenital Heart Disease: a Modern View of the Problem. Ukrainian Journal of Cardiovascular Surgery, (4 (37), 52-56. https://doi.org/10.30702/ujcvs/19.3712/065052-056