Incidence and risk factors of post-operative arrhythmias and sudden cardiac death after atrioventricular septal defect (AVSD) correction: Up to 47 years of follow-up

Rohit K. Kharbanda, Nico A. Blom, Mark G. Hazekamp, Pinar Yildiz, Barbara J. M. Mulder, Ron Wolterbeek, Michel E. Weijerman, Martin J. Schalij, Monique R. M. Jongbloed, Arno A. W. Roest

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background Atrioventricular septal defect (AVSD) has an incidence of 4–5.3 per 10.000 live births and is associated with Down syndrome (DS). Data on arrhythmias and sudden cardiac death (SCD) after AVSD correction is scarce. Aim To analyse the incidence of post-operative arrhythmias and SCD after AVSD correction and explore risk factors. Methods This is a retrospective multicenter study including patients after biventricular AVSD correction. Univariate and multivariate analyses were performed to explore risk factors. Results A total of 415 patients were included with a mean follow-up duration of 9 years (range; < 30 days–47 years). Early post-operative SVTs were documented in 33 patients (8%) and late post-operative SVTs in 15 patients (3.6%). Non-syndromic AVSD (p = 0.022, HR = 2.64; 95% CI = 1.15–6.04) and cAVSD (p = 0.005, HR = 3.7; 95% CI = 1.39–7.51) were independent risk factors for early post-operative SVTs and significant more late post-operative SVTs occurred in non-syndromic patients (p = 0.016, HR = 6.38; 95% CI = 1.42–28.71) and in pAVSD (p = 0.045, HR = 3.703; 95% CI = 1.03–13.32). Fifteen patients (3.6%) received a pacemaker. Non-syndromic AVSD (p = 0.008, HR = 15.82; 95% CI = 2.04–122.47), pAVSD (p = 0.017, HR = 6.26; 95% CI = 1.39–28.28) and re-operation (p = 0.007, HR = 4.911; 95% CI = 1.54–15.64) were independent risk factors for postoperative pacemaker implantation. Late life-threatening ventricular arrhythmias and SCD occurred in 0.5% and 1.7% respectively. Conclusion There is good long-term survival after AVSD correction and incidence of SCD is low. Non-syndromic AVSD and cAVSD are independent risk factors for early post-operative SVTs. Non-syndromic AVSD patients have significant more early 3rd degree AVB and late post-operative SVTs. Non-syndromic patients with partial AVSD who have undergone reoperation have a significant higher risk of pacemaker implantation.
Original languageEnglish
Pages (from-to)88-93
JournalInternational Journal of Cardiology
Volume252
DOIs
Publication statusPublished - 2018
Externally publishedYes

Cite this

Kharbanda, Rohit K. ; Blom, Nico A. ; Hazekamp, Mark G. ; Yildiz, Pinar ; Mulder, Barbara J. M. ; Wolterbeek, Ron ; Weijerman, Michel E. ; Schalij, Martin J. ; Jongbloed, Monique R. M. ; Roest, Arno A. W. / Incidence and risk factors of post-operative arrhythmias and sudden cardiac death after atrioventricular septal defect (AVSD) correction: Up to 47 years of follow-up. In: International Journal of Cardiology. 2018 ; Vol. 252. pp. 88-93.
@article{8e6692b4f82f457d8351c3a2fba2e739,
title = "Incidence and risk factors of post-operative arrhythmias and sudden cardiac death after atrioventricular septal defect (AVSD) correction: Up to 47 years of follow-up",
abstract = "Background Atrioventricular septal defect (AVSD) has an incidence of 4–5.3 per 10.000 live births and is associated with Down syndrome (DS). Data on arrhythmias and sudden cardiac death (SCD) after AVSD correction is scarce. Aim To analyse the incidence of post-operative arrhythmias and SCD after AVSD correction and explore risk factors. Methods This is a retrospective multicenter study including patients after biventricular AVSD correction. Univariate and multivariate analyses were performed to explore risk factors. Results A total of 415 patients were included with a mean follow-up duration of 9 years (range; < 30 days–47 years). Early post-operative SVTs were documented in 33 patients (8{\%}) and late post-operative SVTs in 15 patients (3.6{\%}). Non-syndromic AVSD (p = 0.022, HR = 2.64; 95{\%} CI = 1.15–6.04) and cAVSD (p = 0.005, HR = 3.7; 95{\%} CI = 1.39–7.51) were independent risk factors for early post-operative SVTs and significant more late post-operative SVTs occurred in non-syndromic patients (p = 0.016, HR = 6.38; 95{\%} CI = 1.42–28.71) and in pAVSD (p = 0.045, HR = 3.703; 95{\%} CI = 1.03–13.32). Fifteen patients (3.6{\%}) received a pacemaker. Non-syndromic AVSD (p = 0.008, HR = 15.82; 95{\%} CI = 2.04–122.47), pAVSD (p = 0.017, HR = 6.26; 95{\%} CI = 1.39–28.28) and re-operation (p = 0.007, HR = 4.911; 95{\%} CI = 1.54–15.64) were independent risk factors for postoperative pacemaker implantation. Late life-threatening ventricular arrhythmias and SCD occurred in 0.5{\%} and 1.7{\%} respectively. Conclusion There is good long-term survival after AVSD correction and incidence of SCD is low. Non-syndromic AVSD and cAVSD are independent risk factors for early post-operative SVTs. Non-syndromic AVSD patients have significant more early 3rd degree AVB and late post-operative SVTs. Non-syndromic patients with partial AVSD who have undergone reoperation have a significant higher risk of pacemaker implantation.",
author = "Kharbanda, {Rohit K.} and Blom, {Nico A.} and Hazekamp, {Mark G.} and Pinar Yildiz and Mulder, {Barbara J. M.} and Ron Wolterbeek and Weijerman, {Michel E.} and Schalij, {Martin J.} and Jongbloed, {Monique R. M.} and Roest, {Arno A. W.}",
year = "2018",
doi = "10.1016/j.ijcard.2017.09.209",
language = "English",
volume = "252",
pages = "88--93",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

Incidence and risk factors of post-operative arrhythmias and sudden cardiac death after atrioventricular septal defect (AVSD) correction: Up to 47 years of follow-up. / Kharbanda, Rohit K.; Blom, Nico A.; Hazekamp, Mark G.; Yildiz, Pinar; Mulder, Barbara J. M.; Wolterbeek, Ron; Weijerman, Michel E.; Schalij, Martin J.; Jongbloed, Monique R. M.; Roest, Arno A. W.

In: International Journal of Cardiology, Vol. 252, 2018, p. 88-93.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Incidence and risk factors of post-operative arrhythmias and sudden cardiac death after atrioventricular septal defect (AVSD) correction: Up to 47 years of follow-up

AU - Kharbanda, Rohit K.

AU - Blom, Nico A.

AU - Hazekamp, Mark G.

AU - Yildiz, Pinar

AU - Mulder, Barbara J. M.

AU - Wolterbeek, Ron

AU - Weijerman, Michel E.

AU - Schalij, Martin J.

AU - Jongbloed, Monique R. M.

AU - Roest, Arno A. W.

PY - 2018

Y1 - 2018

N2 - Background Atrioventricular septal defect (AVSD) has an incidence of 4–5.3 per 10.000 live births and is associated with Down syndrome (DS). Data on arrhythmias and sudden cardiac death (SCD) after AVSD correction is scarce. Aim To analyse the incidence of post-operative arrhythmias and SCD after AVSD correction and explore risk factors. Methods This is a retrospective multicenter study including patients after biventricular AVSD correction. Univariate and multivariate analyses were performed to explore risk factors. Results A total of 415 patients were included with a mean follow-up duration of 9 years (range; < 30 days–47 years). Early post-operative SVTs were documented in 33 patients (8%) and late post-operative SVTs in 15 patients (3.6%). Non-syndromic AVSD (p = 0.022, HR = 2.64; 95% CI = 1.15–6.04) and cAVSD (p = 0.005, HR = 3.7; 95% CI = 1.39–7.51) were independent risk factors for early post-operative SVTs and significant more late post-operative SVTs occurred in non-syndromic patients (p = 0.016, HR = 6.38; 95% CI = 1.42–28.71) and in pAVSD (p = 0.045, HR = 3.703; 95% CI = 1.03–13.32). Fifteen patients (3.6%) received a pacemaker. Non-syndromic AVSD (p = 0.008, HR = 15.82; 95% CI = 2.04–122.47), pAVSD (p = 0.017, HR = 6.26; 95% CI = 1.39–28.28) and re-operation (p = 0.007, HR = 4.911; 95% CI = 1.54–15.64) were independent risk factors for postoperative pacemaker implantation. Late life-threatening ventricular arrhythmias and SCD occurred in 0.5% and 1.7% respectively. Conclusion There is good long-term survival after AVSD correction and incidence of SCD is low. Non-syndromic AVSD and cAVSD are independent risk factors for early post-operative SVTs. Non-syndromic AVSD patients have significant more early 3rd degree AVB and late post-operative SVTs. Non-syndromic patients with partial AVSD who have undergone reoperation have a significant higher risk of pacemaker implantation.

AB - Background Atrioventricular septal defect (AVSD) has an incidence of 4–5.3 per 10.000 live births and is associated with Down syndrome (DS). Data on arrhythmias and sudden cardiac death (SCD) after AVSD correction is scarce. Aim To analyse the incidence of post-operative arrhythmias and SCD after AVSD correction and explore risk factors. Methods This is a retrospective multicenter study including patients after biventricular AVSD correction. Univariate and multivariate analyses were performed to explore risk factors. Results A total of 415 patients were included with a mean follow-up duration of 9 years (range; < 30 days–47 years). Early post-operative SVTs were documented in 33 patients (8%) and late post-operative SVTs in 15 patients (3.6%). Non-syndromic AVSD (p = 0.022, HR = 2.64; 95% CI = 1.15–6.04) and cAVSD (p = 0.005, HR = 3.7; 95% CI = 1.39–7.51) were independent risk factors for early post-operative SVTs and significant more late post-operative SVTs occurred in non-syndromic patients (p = 0.016, HR = 6.38; 95% CI = 1.42–28.71) and in pAVSD (p = 0.045, HR = 3.703; 95% CI = 1.03–13.32). Fifteen patients (3.6%) received a pacemaker. Non-syndromic AVSD (p = 0.008, HR = 15.82; 95% CI = 2.04–122.47), pAVSD (p = 0.017, HR = 6.26; 95% CI = 1.39–28.28) and re-operation (p = 0.007, HR = 4.911; 95% CI = 1.54–15.64) were independent risk factors for postoperative pacemaker implantation. Late life-threatening ventricular arrhythmias and SCD occurred in 0.5% and 1.7% respectively. Conclusion There is good long-term survival after AVSD correction and incidence of SCD is low. Non-syndromic AVSD and cAVSD are independent risk factors for early post-operative SVTs. Non-syndromic AVSD patients have significant more early 3rd degree AVB and late post-operative SVTs. Non-syndromic patients with partial AVSD who have undergone reoperation have a significant higher risk of pacemaker implantation.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/29249442

U2 - 10.1016/j.ijcard.2017.09.209

DO - 10.1016/j.ijcard.2017.09.209

M3 - Article

VL - 252

SP - 88

EP - 93

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -