ADULTS with congenital heart disease who go on to develop arrhythmia disorders have been shown to have an increased risk of hospitalisation and mortality, according to new research. With surgical and medical techniques improving in recent years, the number of patients with congenital heart disease surviving to adulthood has increased, meaning complications associated with the disease have done the same.
In order to understand the prevalence of arrhythmias, risk factors, and associated healthcare use in patients with adult congenital heart disease, the research team analysed the electronic health record data of 11,653 patients from 2007–2011 (median age: 47 years). Every patient included in the analysis had at least one congenital heart lesion or congenital heart malformation repair procedure. The patients were all followed for 5 years.
Researchers found that a total of 8.7% of the cohort had tachyarrhythmia at baseline, 1.5% had a conduction disturbance, and 0.5% had both. Among the individuals that had no arrhythmia at baseline, 9.2% developed tachyarrhythmias, 0.9% developed a conduction disturbance, and 0.3% developed both during the study period. Furthermore, arrhythmia in the previous 6 months amongst adults with congenital heart disease was associated with a higher rate of hospitalisation compared to those who experienced no arrhythmia (relative risk [RR] with ventricular arrhythmia: 1.33; 95% confidence interval [CI]: 1.00–1.76; RR with atrial arrhythmias: 1.27; 95% CI: 1.17–1.38; RR with atrioventricular block: 1.33; 95% CI: 1.04–1.70). The team also reported that atrial tachyarrhythmias (hazard ratio: 1.65; 95% CI: 1.44–2.94) and ventricular tachyarrhythmias (hazard ratio: 2.06; 95% CI: 1.44–2.94) were associated with increased mortality risk for patients with adult congenital heart disease.
The authors concluded that their results emphasise the need for lifelong follow-up for individuals with congenital heart disease. “Our study suggests that the development of arrhythmias is a critical point in the life of adult patients with congenital heart disease, and this has a profound impact on the health care system providing care for these patients,” they added.
Reference
Pravda NS et al. Arrhythmia burden among adult patients with congenital heart disease: a population‐based study. J Am Heart Assoc. 2024; DOI:10.1161/JAHA.123.031760.
