SAGUNER, AM, S GANAHL, Andrea KRAUS, SH BALDINGER, A MEDEIROS-DOMINGO, AR SAGUNER, SA MUELLER-BURRI, T WOLBER, LM HAEGELI, N KRASNIQI, FC TANNER, J STEFFEL, C BRUNCKHORST and F DURU. Clinical Role of Atrial Arrhythmias in Patients With Arrhythmogenic Right Ventricular Dysplasia. Circulation Journal. Tokyo: Japanese Circulation Soc, 2014, vol. 78, No 12, p. 2854-2861. ISSN 1346-9843. Available from: https://dx.doi.org/10.1253/circj.CJ-14-0474.
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Basic information
Original name Clinical Role of Atrial Arrhythmias in Patients With Arrhythmogenic Right Ventricular Dysplasia
Authors SAGUNER, AM, S GANAHL, Andrea KRAUS, SH BALDINGER, A MEDEIROS-DOMINGO, AR SAGUNER, SA MUELLER-BURRI, T WOLBER, LM HAEGELI, N KRASNIQI, FC TANNER, J STEFFEL, C BRUNCKHORST and F DURU.
Edition Circulation Journal, Tokyo, Japanese Circulation Soc, 2014, 1346-9843.
Other information
Original language English
Type of outcome Article in a journal
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 3.940
Doi http://dx.doi.org/10.1253/circj.CJ-14-0474
UT WoS 000346698300013
Keywords in English Arrhythmogenic right ventricular dysplasia; Atrial fibrillation; Atrial flutter; Cardiomyopathy
Tags International impact, Reviewed
Changed by Changed by: Mgr. Andrea Kraus, M.Sc., Ph.D., učo 238225. Changed: 12/1/2016 23:07.
Abstract
Background: The clinical role of atrial fibrillation/atrial flutter (AF-AFl) and variables predicting these arrhythmias are not well defined in patients with arrhythmogenic right ventricular dysplasia (ARVD). We hypothesized that transthoracic echocardiography (TTE) and 12-lead electrocardiography (ECG) would be helpful in predicting AF-AFl in these patients. Methods and Results: ECGs and TTEs of 90 patients diagnosed with definite or borderline ARVD (2010 Task Force Criteria) were analyzed. Data were compared in (1) patients with AF-AFl and (2) all other patients. A total of 18 (20%) patients experienced AF-AFl during a median follow-up of 5.8 years (interquartile range 2.0-10.4). Kaplan-Meier analysis revealed reduced times to AF-AFl among patients with echocardiographic RV fractional area change <27% (P<0.001), left atrial diameter >= 24.4 mm/m(2) (parasternal long-axis, P=0.001), and right atrial short-axis diameter >= 22.1 mm/m(2) (apical 4-chamber view, P=0.05). From all ECG variables, P mitrale conferred the highest hazard ratio (3.37, 95% confidence interval 0.92-12.36, P=0.067). Five patients with AF-AFl experienced inappropriate implantable cardioverter-defibrillator (ICD) shocks compared with 4 without AF-AFl (36% vs. 9%, P=0.03). AF-AFl was more prevalent in heart-transplant patients and those who died of cardiac causes (56% vs. 16%, P=0.014). Conclusions: AF-AFl is associated with inappropriate ICD shocks, heart transplantation, and cardiac death in patients with ARVD. Evidence of reduced RV function and atrial dilation helps to identify the ARVD patients at increased risk for AF-AFl.
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