Atrial flutter/fibrillation in adult congenital heart disease: Insights from a large Asian cohort
Background: The incidence of atrial fibrillation/atrial flutter (AF/AFL) in general population is lower in Asia compared to Western countries. It is unclear whether a similar trend exists among adults with congenital heart disease (ACHD). We determine the profile, risk factors, and impact of AF/AFL...
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Elsevier
2025-02-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664624003437 |
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| author | Shuenn-Nan Chiu Wei-Chieh Tseng Chun-Wei Lu Ming-Tai Lin Chun-An Chen Jou-Kou Wang Mei-Hwan Wu |
| author_facet | Shuenn-Nan Chiu Wei-Chieh Tseng Chun-Wei Lu Ming-Tai Lin Chun-An Chen Jou-Kou Wang Mei-Hwan Wu |
| author_sort | Shuenn-Nan Chiu |
| collection | DOAJ |
| description | Background: The incidence of atrial fibrillation/atrial flutter (AF/AFL) in general population is lower in Asia compared to Western countries. It is unclear whether a similar trend exists among adults with congenital heart disease (ACHD). We determine the profile, risk factors, and impact of AF/AFL in an Asian ACHD cohort. Methods: We included all ACHD patients diagnosed in an Asia tertiary care center between 2007 and 2018, analyzing AF (sustained and paroxysmal AF) and AFL, collectively./Purpose. Results: The study encompassed 4391 patients (55.9% women), with 81% having simple, 16.3% moderate and 2.8% severe CHD. AF/AFL was observed in 6.7% of the patients, with 54.6% having paroxysmal AF, 27.3% sustained AF, and 18.1% AFL. Incidence of AF/AFL increased with age and was higher in patients with pulmonary hypertension (PH), severe CHD, and metabolic syndrome. We found a progressive trend in the onset age of arrhythmia: AFL at a younger age, followed by paroxysmal and sustained AF. Risk factors for AF/AFL included severe and moderate CHD, PH, previous interventions, and male sex (odds ratio 11.2 and 3.15, 2.03, 1.75, and 1.71, respectively). When stratifying by CHD severity, PH and male sex were significant risk factors in simple CHD, while only PH in severe CHD. Patients with AF/AFL had a significantly lower major adverse cardiovascular events-free survival rate. Conclusion: This large ACHD cohort from Asia exhibited a high incidence of AF/AFL, similar to Western reports. The risk of AF/AFL was primarily associated with hemodynamic factors such as PH and CHD severity. |
| format | Article |
| id | doaj-art-4d78f504281e402e84a8adb598716696 |
| institution | Kabale University |
| issn | 0929-6646 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj-art-4d78f504281e402e84a8adb5987166962025-02-02T05:26:47ZengElsevierJournal of the Formosan Medical Association0929-66462025-02-011242126132Atrial flutter/fibrillation in adult congenital heart disease: Insights from a large Asian cohortShuenn-Nan Chiu0Wei-Chieh Tseng1Chun-Wei Lu2Ming-Tai Lin3Chun-An Chen4Jou-Kou Wang5Mei-Hwan Wu6Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, TaiwanCorresponding author. Department of Pediatrics, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.; Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, TaiwanCorresponding author. Department of Pediatrics, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.; Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei, TaiwanBackground: The incidence of atrial fibrillation/atrial flutter (AF/AFL) in general population is lower in Asia compared to Western countries. It is unclear whether a similar trend exists among adults with congenital heart disease (ACHD). We determine the profile, risk factors, and impact of AF/AFL in an Asian ACHD cohort. Methods: We included all ACHD patients diagnosed in an Asia tertiary care center between 2007 and 2018, analyzing AF (sustained and paroxysmal AF) and AFL, collectively./Purpose. Results: The study encompassed 4391 patients (55.9% women), with 81% having simple, 16.3% moderate and 2.8% severe CHD. AF/AFL was observed in 6.7% of the patients, with 54.6% having paroxysmal AF, 27.3% sustained AF, and 18.1% AFL. Incidence of AF/AFL increased with age and was higher in patients with pulmonary hypertension (PH), severe CHD, and metabolic syndrome. We found a progressive trend in the onset age of arrhythmia: AFL at a younger age, followed by paroxysmal and sustained AF. Risk factors for AF/AFL included severe and moderate CHD, PH, previous interventions, and male sex (odds ratio 11.2 and 3.15, 2.03, 1.75, and 1.71, respectively). When stratifying by CHD severity, PH and male sex were significant risk factors in simple CHD, while only PH in severe CHD. Patients with AF/AFL had a significantly lower major adverse cardiovascular events-free survival rate. Conclusion: This large ACHD cohort from Asia exhibited a high incidence of AF/AFL, similar to Western reports. The risk of AF/AFL was primarily associated with hemodynamic factors such as PH and CHD severity.http://www.sciencedirect.com/science/article/pii/S0929664624003437Adult congenital heart diseaseAtrial fibrillationCongenital heart disease severityMajor adverse cardiovascular eventsPulmonary hypertension |
| spellingShingle | Shuenn-Nan Chiu Wei-Chieh Tseng Chun-Wei Lu Ming-Tai Lin Chun-An Chen Jou-Kou Wang Mei-Hwan Wu Atrial flutter/fibrillation in adult congenital heart disease: Insights from a large Asian cohort Journal of the Formosan Medical Association Adult congenital heart disease Atrial fibrillation Congenital heart disease severity Major adverse cardiovascular events Pulmonary hypertension |
| title | Atrial flutter/fibrillation in adult congenital heart disease: Insights from a large Asian cohort |
| title_full | Atrial flutter/fibrillation in adult congenital heart disease: Insights from a large Asian cohort |
| title_fullStr | Atrial flutter/fibrillation in adult congenital heart disease: Insights from a large Asian cohort |
| title_full_unstemmed | Atrial flutter/fibrillation in adult congenital heart disease: Insights from a large Asian cohort |
| title_short | Atrial flutter/fibrillation in adult congenital heart disease: Insights from a large Asian cohort |
| title_sort | atrial flutter fibrillation in adult congenital heart disease insights from a large asian cohort |
| topic | Adult congenital heart disease Atrial fibrillation Congenital heart disease severity Major adverse cardiovascular events Pulmonary hypertension |
| url | http://www.sciencedirect.com/science/article/pii/S0929664624003437 |
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