Cited by 476Congenital Heart Disease StudiesCardiovascular and Diving-Related ComplicationsCardiac Arrhythmias and Treatments

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Atrial Arrhythmias in Adults With Congenital Heart Disease

Bouchardy, Judith, Therrien, Judith, Pilote, Louise, Ionescu-Ittu, Raluca, Martucci, Giuseppe, Bottega, Natalie, Marelli, Ariane J.·2009·Circulation

DOI 10.1161/circulationaha.109.866319

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Abstract

Background Atrial arrhythmias increase disease burden in the general adult population. Adults with congenital heart lesions constitute a rapidly growing group of patients with cardiovascular disease. We hypothesized that atrial arrhythmias increase with age and impair health outcomes in this population. Methods and results We conducted a population-based analysis of prevalence, lifetime risk, mortality, and morbidity associated with atrial arrhythmias in adults with congenital heart disease from l983 to 2005. In 38 428 adults with congenital heart disease in 2005, 5812 had atrial arrhythmias. Overall, the 20-year risk of developing atrial arrhythmia was 7% in a 20-year-old subject and 38% in a 50-year-old subject. More than 50% of patients with severe congenital heart disease reaching age 18 years developed atrial arrhythmias by age 65 years. In patients with congenital heart disease, the hazard ratio of any adverse event in those with atrial arrhythmias compared with those without was 2.50 (95% confidence interval, 2.38 to 2.62; P Conclusions Atrial arrhythmias occurred in 15% of adults with congenital heart disease. The lifetime incidence increased steadily with age and was associated with a doubling of the risk of adverse events. An increase in resource allocation should be anticipated to deal with this increasing burden.

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Background
Catheter ablation of typical right atrial flutter in a 20‐day‐old neonate with tachycardiomyopathy
Leiria, T., Cabral, I., Schäfer, S., Nicoloso, L. H., Rossi, R., Kruse, M., Saffi, M., & de Lima, G. D. (2023) · Journal of Arrhythmia · doi:10.1002/joa3.12964 · Cited by 4
“10 Furthermore, the literature suggests that even following ASD device closure, there is a heightened risk of arrhythmia recurrence with elevated pulmonary arterial pressure leading to right-sided overload.”
Background
COVID-19–Related Thrombotic and Bleeding Events in Adults With Congenital Heart Disease
Fusco, F., Krasuski, R. A., Sadeghi, S., Rosenbaum, M., Lewis, M., Carazo, M., Rodriguez, F. H., Halpern, D. G., Feinberg, J. L., Arancibia-Galilea, F., et al. (2023) · JACC Advances · doi:10.1016/j.jacadv.2023.100701 · Cited by 3
Self-citation
Catheter ablation of atrial tachyarrhythmias in patients with atrioventricular septal defect
Waldmann, V., Bessière, F., Gardey, K., Hascoët, S., Hénaine, R., Iserin, L., Ladouceur, M., Bonnet, D., Marijon, É., Maltret, A., et al. (2023) · EP Europace · doi:10.1093/europace/euad275 · Cited by 5
“Projections indicate that half of 20-year-old patients with complex CHD will have an atrial tachyarrhythmia during their lifespan.(1) Invasive approaches such as ablation therapy have demonstrated their superiority over pharmacological antiarrhythmic treatment and are now recommend as first-line therapy.”
Background
Cellular and Molecular Mechanisms Underlying Tricuspid Valve Development and Disease
Salerno, N., Panuccio, G., Sabatino, J., Leo, I., Torella, M., Sorrentino, S., de Rosa, S., & Torella, D. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12103454 · Cited by 4
“such proximity to the AV node that they are susceptible to damage during surgery [11].”
Background
Atrial fibrillation in young hospitalized patients: clinical characteristics, predictors of new onset, and outcomes.
Segev, A., Maor, E., Goldenfeld, M., Itelman, E., Grossman, E., Beinart, R., Leshem, E., Klempfner, R., Klang, E., Rahman, N., et al. (2023) · Journal of Cardiology · doi:10.1016/j.jjcc.2023.04.013 · Cited by 4
The patient with congenital heart disease in ambulatory surgery
Eerdekens, G.-J., Beersel, D. V., Rex, S., Gewillig, M. H. M. L., Schrijvers, A., & Tmimi, L. A. (2022) · Best practice & research. Clinical anaesthesiology · doi:10.1016/j.bpa.2022.11.006 · Cited by 5
“Arrhythmias, particularly atrial arrhythmias, are associated with an increased risk of hospital admission and morbidity in CHD patients [42,43].”
Background
PentaRay® Multielectrode Mapping Catheter for Atrial Tachyarrhythmia in Adults With Congenital Heart Disease.
Dodeja, A. K., Tan, Y., Ackley, T., Russell, J., Kertesz, N., Daniels, C. J., & Kamp, A. (2022) · Texas Heart Institute Journal · doi:10.14503/thij-20-7535 · Cited by 4
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Self-citation
Outcome of ACHD patients with non-inducible versus inducible IART undergoing cavo-tricuspid isthmus ablation: the role of empiric ablation
Sawhney, V., Lellan, A. M., Chatha, S., Perera, D., Aderonke, A., Juno, S., Whittaker-Axon, S., Daw, H., Garcia, J., Lambiase, P., et al. (2020) · Journal of interventional cardiac electrophysiology · doi:10.1007/s10840-019-00692-y · Cited by 4
Improvement in ventricular function with rhythm control of atrial arrhythmias may delay the need for atrioventricular valve surgery in adults with congenital heart disease
Zielonka, B., Kim, Y. Y., Supple, G. E., Partington, S. L., Ruckdeschel, E. S., Marchlinski, F. E., & Frankel, D. S. (2019) · Congenital Heart Disease · doi:10.1111/chd.12833 · Cited by 5
Risks and outcomes of direct current cardioversion in children and young adults with congenital heart disease
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Thromboembolic episodes related to atrial arrhythmias in adults with transposition of great arteries
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“With continued follow up, this group of patients with TGA in adulthood will continue to experience worsening of late complications and place a growing burden on existing limited healthcare resources [19].”
Background
Evaluation and Management of Maternal Cardiac Arrhythmias.
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Maximizing the Effectiveness of Ablation for Arrhythmias in the Congenital Heart Patients
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Postoperative Care of the Adult With Congenital Heart Disease
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Transcatheter closure of patent ductus arteriosus in adults
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Heart Failure in Women with Congenital Heart Disease
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When Your 35-Year-Old Patient has a Sternotomy Scar: Anesthesia for Adult Patients with Congenital Heart Disease Presenting for Noncardiac Surgery.
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“A detailed history and physical examination will provide information on exercise tolerance, cyanosis, and signs and symptoms of heart failure; a preoperative electrocardiogram will elucidate any arrhythmias and/or conduction defects.(21,22) Preoperative echocardiography is generally desirable to provide details of the…”
Background
Arrhythmias in adult patients after Rastelli surgery: a single-centre experience
Patloori, S. C. S., Kawada, S., Chakraborty, P., Saeed, Y., Denham, N. C., Joens, C., Oechslin, E., Roche, S., Silversides, C., Wald, R., et al. (2024) · Cardiology in the Young · doi:10.1017/s1047951124026623 · Cited by 3
Arrhythmias in Adult Congenital Heart Disease Heart Failure.
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Impact of atrial tachycardia management on outcomes in adult patients with congenital heart disease
Gallet, J., Waldmann, V., Gloan, L. L., Guérin, P., Gourraud, J., Amet, D., Laredo, M., Iserin, L., Marijon, É., & Ladouceur, M. (2021) · International Journal of Cardiology Congenital Heart Disease · doi:10.1016/j.ijcchd.2021.100229 · Cited by 3
Diagnostic and Therapeutic Approach to Arrhythmias in Adult Congenital Heart Disease
Guerrier, K., Hendrickson, B., Waller, B. R., & Wetzel, G. T. (2019) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-019-0749-9 · Cited by 3
Postoperative and short-term atrial tachyarrhythmia burdens after transcatheter vs surgical pulmonary valve replacement among congenital heart disease patients.
Wadia, S. K., Lluri, G., Aboulhosn, J., Laks, H., Biniwale, R., Arsdell, G. V., Levi, D., Salem, M. M., Shannon, K., & Moore, J. (2019) · Congenital Heart Disease · doi:10.1111/chd.12818 · Cited by 3
Electrophysiology and structural interventions in adults with congenital heart disease: Comparison of combined versus separate procedures
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“Significant findings in this study include improvements in (1) patient-related factors, such as anesthetic exposures, number of venipunctures, and time required off work, (2) health system-related factors, including a reduction in procedure-related charges and subsequent payments, and (3) both patient and health syste…”
BackgroundInfluential
Atrial arrhythmias in adults with congenital heart disease. Listening to your heart sound can save your life.
Limongelli, G., & Sarubbi, B. (2017) · International Journal of Cardiology · doi:10.1016/j.ijcard.2017.08.029 · Cited by 3
Herzrhythmusstörungen bei Erwachsenen mit angeborenem Herzfehler
Hessling, G. (2016) · Herzschrittmachertherapie & Elektrophysiologie · doi:10.1007/s00399-016-0430-x · Cited by 3
Atrial fibrillation and stroke after atrial septal defect closure. Is earlier closure warranted?
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Circulation: Clinical Summaries Original Research Put Into Perspective for the Practicing Clinician
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Self-citation
Atrial arrhythmias: a "call to arms" for congenital heart disease caregivers.
Landzberg, M., & Cecchin, F. (2009) · Circulation · doi:10.1161/circulationaha.109.899310 · Cited by 3
Congenital Heart Disease: A Life-Cycle Condition – Understanding Demographic Trends and Estimating Disease Burden
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Self-citation
Exercise Training in Congenital Heart Diseases
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Burchill, L., Desai, V. K., Jokhadar, M., Dezfulian, C., Connolly, H. M., Egbe, A., Miranda, W., Jain, C., & Jentzer, J. (2025) · JACC: Advances · doi:10.1016/j.jacadv.2025.101710 · Cited by 2
Very High‐Power Short‐Duration Ablation for Atrial Fibrillation in Adults With Congenital Heart Disease
Lengauer, S., Erhard, N., Popa, M., Telishevska, M., Krafft, H., Bahlke, F., Englert, F., Bourier, F., Reents, T., Deisenhofer, I., et al. (2025) · Cardiovascular Electrophysiology · doi:10.1111/jce.16567 · Cited by 2
“Atrial fibrillation (AF) has already surpassed intra ‐ atrial reentrant tachycardia (IART) as leading atrial arrhythmia in ACHD patients older than 50 years [4].”
Clinical course and outcomes of supravalvular aortic stenosis in adults
de Keijzer, A. D., Keuning, Z., Meccanici, F., van Kimmenade, R., Melle, J. V. V., Bouma, B., Kluin, J., Jongbloed, M., Voskuil, M., Roos-Hesselink, J., et al. (2025) · Open Heart · doi:10.1136/openhrt-2025-003355 · Cited by 2
“Moreover, it is known that (sub)valvular aortic stenosis as an additional source of LVOT obstruction can expose the left ventricle to high pressures, resulting in heart failure and arrhythmias.”
Association of reduced peak left atrial strain with supraventricular arrhythmia in adults with congenital heart disease
Nussbaumer, C., Schwerzmann, M., Elchinova, E., Goulouti, E., Tobler, D., Greutmann, M., Wustmann, K., Papa, A., & Schwitz, F. (2024) · The International Journal of Cardiovascular Imaging · doi:10.1007/s10554-024-03205-9 · Cited by 2
Tempering the Storm of Arrhythmias in Adults With Congenital Heart Disease
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Adult Congenital Heart Disease in the Aging and Elderly Population
Cai, A. W., Pistner, A. R., & Krieger, E. V. (2023) · Current Geriatrics Reports · doi:10.1007/s13670-023-00396-2 · Cited by 2
“Compared to patients with CHD that were arrhythmia free, those with atrial arrhythmias had a 2-to 3-fold increased risk of congestive heart failure or need for cardiac intervention and a >50% increased risk of stroke [22].”
Enhancing Generalization in Arrhythmia Classification with Attention MechanismsPreprint
Huang, Z.-J., MacLachlan, S., Truong, N. D., & Kavehei, O. (2023) · medRxiv · doi:10.1101/2023.07.05.23292238 · Cited by 2
“The incidence of arrhythmias tends to increase with age and is also influenced by other factors such as hypertension, diabetes, and pre-existing heart disease [5] [8].”
Background
Management for atrial arrhythmias in adults with complex congenital heart disease
Waldmann, V., Vô, C., Bartoletti, S., Bessière, F., Wilkin, M., Dib, N., Combes, N., & Khairy, P. (2023) · Expert Review of Cardiovascular Therapy · doi:10.1080/14779072.2023.2219057 · Cited by 1
“of 20-year-olds with complex CHD will experience an atrial tachyarrhythmia during their lifespan [4].”
Background
Contemporary Trends and Comparison of Racial Differences in Hospitalizations of Adults With Congenital Heart Disease.
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Factors Determining Occurrence of Arrhythmias in Patients Post-closure of Atrial Septal Defects
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“Based on risk stratification estimated using the different factors, it will guide decisions regarding follow-up and treatment [6].”
Method
Impact of Catheter Ablation for Atrial Arrhythmias on Repeat Cardioversion in Adults With Congenital Heart Disease
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Impact of Disease Complexity on Cardiovascular Events after the Transition to an Adult Congenital Heart Disease Specialized Medical Unit.
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Force Trends and Pulsatility for Catheter Contact Identification in Intracardiac Electrograms during Arrhythmia Ablation
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Authors: Bouchardy, J., Therrien, J., Pilote, L., Ionescu-Ittu, R., Martucci, G., Bottega, N., & Marelli, A. J.
Affiliations: McGill University Health Centre (CA)
From the McGill Adult Unit for Congenital Heart Disease Excellence, McGill University Health Center and the Jewish General Hospital (J.B., J.T., R.I.-I., G.M., N.B., A.J.M.) and Division of Internal Medicine, McGill University Health Centre Research Institute (L.P., R.I.-I.), Montreal, Quebec, Canada.
ORCID: Bouchardy, Judith
Therrien, Judith
Pilote, Louise
Martucci, Giuseppe
Marelli, Ariane J.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2009-10-27
Volume: 120
Issue: 17
Pages: 1679-1686
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.109.866319
OpenAlex: W2075290555
Cited by: 476
References: 0
Citations by year: 2026: 23 · 2025: 26 · 2024: 33 · 2023: 36 · 2022: 22 · 2021: 30 · 2020: 32 · 2019: 34 · 2018: 44 · 2017: 47 · 2016: 25 · 2015: 34 · 2014: 18 · 2013: 24 · 2012: 20
FWCI: 10.52
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
IRIS (submittedVersion)
SERVAL (Université de Lausanne) (submittedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Keywords: atrial arrhythmias, adult congenital heart disease, atrial fibrillation, lifetime risk, prevalence, mortality, stroke, heart failure, cardiac interventions, health burden, aging
MeSH terms: Adult, Age Factors, Aged, Atrial Fibrillation, Female, Follow-Up Studies, Heart Defects, Congenital, Humans, Male, Middle Aged, Population Surveillance, Retrospective Studies, Cohort Studies, Young Adult

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Atrial Arrhythmias in Adults With Congenital Heart Disease

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