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.
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 ARVDpatients at increased risk for AF-AFl.
Authors: Guoliang Li; Guy H Fontaine; Shuanliang Fan; Yang Yan; Peter K Bode; Firat Duru; Robert Frank; Ardan M Saguner Journal: Cardiol J Date: 2018-11-05 Impact factor: 2.737
Authors: Anneline S J M Te Riele; Esperanza Agullo-Pascual; Cynthia A James; Alejandra Leo-Macias; Marina Cerrone; Mingliang Zhang; Xianming Lin; Bin Lin; Nara L Sobreira; Nuria Amat-Alarcon; Roos F Marsman; Brittney Murray; Crystal Tichnell; Jeroen F van der Heijden; Dennis Dooijes; Toon A B van Veen; Harikrishna Tandri; Steven J Fowler; Richard N W Hauer; Gordon Tomaselli; Maarten P van den Berg; Matthew R G Taylor; Francesca Brun; Gianfranco Sinagra; Arthur A M Wilde; Luisa Mestroni; Connie R Bezzina; Hugh Calkins; J Peter van Tintelen; Lei Bu; Mario Delmar; Daniel P Judge Journal: Cardiovasc Res Date: 2017-01 Impact factor: 10.787
Authors: Jonathan S Steinberg; Niraj Varma; Iwona Cygankiewicz; Peter Aziz; Paweł Balsam; Adrian Baranchuk; Daniel J Cantillon; Polychronis Dilaveris; Sergio J Dubner; Nabil El-Sherif; Jaroslaw Krol; Malgorzata Kurpesa; Maria Teresa La Rovere; Suave S Lobodzinski; Emanuela T Locati; Suneet Mittal; Brian Olshansky; Ewa Piotrowicz; Leslie Saxon; Peter H Stone; Larisa Tereshchenko; Mintu P Turakhia; Gioia Turitto; Neil J Wimmer; Richard L Verrier; Wojciech Zareba; Ryszard Piotrowicz Journal: Ann Noninvasive Electrocardiol Date: 2017-05 Impact factor: 1.468
Authors: Guo-Liang Li; Ardan M Saguner; Guy Hugues Fontaine; Robert Frank Journal: Ann Noninvasive Electrocardiol Date: 2018-07-05 Impact factor: 1.468
Authors: Utku Gülan; Ardan Muammer Saguner; Deniz Akdis; Alexander Gotschy; Felix C Tanner; Sebastian Kozerke; Robert Manka; Corinna Brunckhorst; Markus Holzner; Firat Duru Journal: Sci Rep Date: 2019-01-14 Impact factor: 4.379