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@article{1324041, author = {Saguner, AM and Ganahl, S and Kraus, Andrea and Baldinger, SH and MedeirosandDomingo, A and Saguner, AR and MuellerandBurri, SA and Wolber, T and Haegeli, LM and Krasniqi, N and Tanner, FC and Steffel, J and Brunckhorst, C and Duru, F}, article_location = {Tokyo}, article_number = {12}, doi = {http://dx.doi.org/10.1253/circj.CJ-14-0474}, keywords = {Arrhythmogenic right ventricular dysplasia; Atrial fibrillation; Atrial flutter; Cardiomyopathy}, language = {eng}, issn = {1346-9843}, journal = {Circulation Journal}, title = {Clinical Role of Atrial Arrhythmias in Patients With Arrhythmogenic Right Ventricular Dysplasia}, volume = {78}, year = {2014} }
TY - JOUR ID - 1324041 AU - Saguner, AM - Ganahl, S - Kraus, Andrea - Baldinger, SH - Medeiros-Domingo, A - Saguner, AR - Mueller-Burri, SA - Wolber, T - Haegeli, LM - Krasniqi, N - Tanner, FC - Steffel, J - Brunckhorst, C - Duru, F PY - 2014 TI - Clinical Role of Atrial Arrhythmias in Patients With Arrhythmogenic Right Ventricular Dysplasia JF - Circulation Journal VL - 78 IS - 12 SP - 2854-2861 EP - 2854-2861 PB - Japanese Circulation Soc SN - 13469843 KW - Arrhythmogenic right ventricular dysplasia KW - Atrial fibrillation KW - Atrial flutter KW - Cardiomyopathy N2 - 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. ER -
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. \textit{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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