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Arrhythmias in patients with hypoplastic left heart syndrome.

Publication ,  Journal Article
Trivedi, B; Smith, PB; Barker, PCA; Jaggers, J; Lodge, AJ; Kanter, RJ
Published in: Am Heart J
January 2011

BACKGROUND: Mortality between stage I and II palliation for hypoplastic left heart syndrome (HLHS) has been associated with arrhythmias. The stage-related proportion, associations, and clinical impact of arrhythmias in patients with HLHS have not been evaluated. In addition, arrhythmia subtypes have not been described in this patient group. METHODS: We performed a retrospective analysis of all patients at Duke University Medical Center who received one or more palliative stages for HLHS from September 2000 to October 2008. RESULTS: Overall, 49 (57%) of 86 patients had 63 arrhythmias. The majority of arrhythmias occurred between stage I and II, with 44 (51%) of 86 patients manifesting a new arrhythmia. Arrhythmias occurring in this interval tended to be associated with a higher mortality compared with arrhythmias occurring after stage II (odds ratio = 3.2 [95% CI 0.84-12.0], P = .09). Overall mortality was similar in patients with and without arrhythmias (P = .99). Supraventricular tachycardia was the most common arrhythmia (16/63; 25%), but persistent bradycardias (sinus node dysfunction or high-grade atrioventricular block) had the worst clinical outcome with 73% mortality (8/11). There was no association between arrhythmia occurrence and degree of tricuspid regurgitation, left ventricular hypertension, genetic syndrome, type of stage I operation, or need for extracorporeal membrane oxygenation. CONCLUSIONS: A large proportion of patients with HLHS experience serious arrhythmias requiring therapy, especially between stage I and II. Persistent bradycardia following stage I is associated with a high mortality rate. Considering all arrhythmia patients, overall mortality was not different compared with the arrhythmia-free group.

Duke Scholars

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

January 2011

Volume

161

Issue

1

Start / End Page

138 / 144

Location

United States

Related Subject Headings

  • Time Factors
  • Retrospective Studies
  • Prognosis
  • Male
  • Infant, Newborn
  • Infant
  • Hypoplastic Left Heart Syndrome
  • Humans
  • Heart Rate
  • Follow-Up Studies
 

Citation

APA
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ICMJE
MLA
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Trivedi, B., Smith, P. B., Barker, P. C. A., Jaggers, J., Lodge, A. J., & Kanter, R. J. (2011). Arrhythmias in patients with hypoplastic left heart syndrome. Am Heart J, 161(1), 138–144. https://doi.org/10.1016/j.ahj.2010.09.027
Trivedi, Bhavya, P Brian Smith, Piers C. A. Barker, James Jaggers, Andrew J. Lodge, and Ronald J. Kanter. “Arrhythmias in patients with hypoplastic left heart syndrome.Am Heart J 161, no. 1 (January 2011): 138–44. https://doi.org/10.1016/j.ahj.2010.09.027.
Trivedi B, Smith PB, Barker PCA, Jaggers J, Lodge AJ, Kanter RJ. Arrhythmias in patients with hypoplastic left heart syndrome. Am Heart J. 2011 Jan;161(1):138–44.
Trivedi, Bhavya, et al. “Arrhythmias in patients with hypoplastic left heart syndrome.Am Heart J, vol. 161, no. 1, Jan. 2011, pp. 138–44. Pubmed, doi:10.1016/j.ahj.2010.09.027.
Trivedi B, Smith PB, Barker PCA, Jaggers J, Lodge AJ, Kanter RJ. Arrhythmias in patients with hypoplastic left heart syndrome. Am Heart J. 2011 Jan;161(1):138–144.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

January 2011

Volume

161

Issue

1

Start / End Page

138 / 144

Location

United States

Related Subject Headings

  • Time Factors
  • Retrospective Studies
  • Prognosis
  • Male
  • Infant, Newborn
  • Infant
  • Hypoplastic Left Heart Syndrome
  • Humans
  • Heart Rate
  • Follow-Up Studies