Benjamin Casteigt1, Michelle Samuel1, Laurence Laplante1, Azadeh Shohoudi1, Silke Apers2, Adrienne H Kovacs3, Koen Luyckx4, Corina Thomet5, Werner Budts6, Junko Enomoto7, Maayke A Sluman8, Chun-Wei Lu9, Jamie L Jackson10, Stephen C Cook11, Shanthi Chidambarathanu12, Luis Alday13, Katrine Eriksen14, Mikael Dellborg15, Malin Berghammer16, Bengt Johansson17, Andrew S Mackie18, Samuel Menahem19, Maryanne Caruana20, Gruschen Veldtman21, Alexandra Soufi22, Susan M Fernandes23, Kamila White24, Edward Callus25, Shelby Kutty26, Judith Brouillette1, Philip Moons27, Paul Khairy28. 1. Montreal Heart Institute, Université de Montréal, Montreal, Canada. 2. KU Leuven Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium. 3. Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon. 4. KU Leuven-University of Leuven, Psychology and Development in Context, Leuven, Belgium and UNIBS, University of the Free State, Bloemfontein, South Africa. 5. Center for Congenital Heart Disease, Inselspital-Bern University Hospital, University of Bern, Bern, Switzerland. 6. Division of Congenital and Structural Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium. 7. Department of Adult Congenital Heart Disease, Chiba Cardiovascular Center, Chiba, Japan. 8. Department of Cardiology, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands and Coronel Institute for Occupational Health, Academic Medical Centre, Amsterdam, the Netherlands. 9. Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. 10. Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, Ohio. 11. Adult Congenital Heart Disease Center, Helen DeVos Children's Hospital, Grand Rapids, Michigan. 12. Frontier Lifeline Hospital (Dr. K.M. Cherian Heart Foundation), Chennai, India. 13. Division of Cardiology, Hospital de Niños, Córdoba, Argentina. 14. Department of Cardiology, Oslo University Hospital-Rikshospitalet, Oslo, Norway. 15. Adult Congenital Heart Unit, Sahlgrenska University Hospital/Östra, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 16. Centre for Person-Centred Care (GPCC), University of Gothenburg and Department of Health Sciences, University West, Trollhättan, Sweden. 17. Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. 18. Division of Cardiology, Stollery Children's Hospital, University of Alberta, Edmonton, Canada. 19. Monash Medical Centre, Monash University, Melbourne, Australia. 20. Department of Cardiology, Mater Dei Hospital, Birkirkara Bypass, Malta. 21. Adult Congenital Heart Disease Center, Cincinnati Children's Hospital, Cincinnati, Ohio. 22. Department of Congenital Heart Disease, Louis Pradel Hospital, Lyon, France. 23. Department of Pediatrics and Medicine, Stanford University School of Medicine, Palo Alto, California. 24. Adult Congenital Heart Disease Center, Washington University and Barnes Jewish Heart & Vascular Center, and University of Missouri, Saint Louis, Missouri. 25. Clinical Psychology Service, IRCCS Policlinico San Donato, Milan, Italy and Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy. 26. Adult Congenital Heart Disease Center, University of Nebraska Medical Center/Children's Hospital & Medical Center, Omaha, Nebraska. 27. KU Leuven-University of Leuven, Department of Public Health and Primary Care, Leuven, Belgium Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden, and Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa. 28. Montreal Heart Institute, Université de Montréal, Montreal, Canada. Electronic address: paul.khairy@umontreal.ca.
Abstract
BACKGROUND: Atrial arrhythmias (ie, intra-atrial reentrant tachycardia and atrial fibrillation) are a leading cause of morbidity and hospitalization in adults with congenital heart disease (CHD). Little is known about their effect on quality of life and other patient-reported outcomes (PROs) in adults with CHD. OBJECTIVE: The purpose of this study was to assess the impact of atrial arrhythmias on PROs in adults with CHD and explore geographic variations. METHODS: Associations between atrial arrhythmias and PROs were assessed in a cross-sectional study of adults with CHD from 15 countries spanning 5 continents. A propensity-based matching weight analysis was performed to compare quality of life, perceived health status, psychological distress, sense of coherence, and illness perception in patients with and those without atrial arrhythmias. RESULTS: A total of 4028 adults with CHD were enrolled, 707 (17.6%) of whom had atrial arrhythmias. After applying matching weights, patients with and those without atrial arrhythmias were comparable with regard to age (mean 40.1 vs 40.2 years), demographic variables (52.5% vs 52.2% women), and complexity of CHD (15.9% simple, 44.8% moderate, and 39.2% complex in both groups). Patients with atrial arrhythmias had significantly worse PRO scores with respect to quality of life, perceived health status, psychological distress (ie, depression), and illness perception. A summary score that combines all PRO measures was significantly lower in patients with atrial arrhythmias (-3.3%; P = .0006). Differences in PROs were consistent across geographic regions. CONCLUSION: Atrial arrhythmias in adults with CHD are associated with an adverse impact on a broad range of PROs consistently across various geographic regions.
BACKGROUND: Atrial arrhythmias (ie, intra-atrial reentrant tachycardia and atrial fibrillation) are a leading cause of morbidity and hospitalization in adults with congenital heart disease (CHD). Little is known about their effect on quality of life and other patient-reported outcomes (PROs) in adults with CHD. OBJECTIVE: The purpose of this study was to assess the impact of atrial arrhythmias on PROs in adults with CHD and explore geographic variations. METHODS: Associations between atrial arrhythmias and PROs were assessed in a cross-sectional study of adults with CHD from 15 countries spanning 5 continents. A propensity-based matching weight analysis was performed to compare quality of life, perceived health status, psychological distress, sense of coherence, and illness perception in patients with and those without atrial arrhythmias. RESULTS: A total of 4028 adults with CHD were enrolled, 707 (17.6%) of whom had atrial arrhythmias. After applying matching weights, patients with and those without atrial arrhythmias were comparable with regard to age (mean 40.1 vs 40.2 years), demographic variables (52.5% vs 52.2% women), and complexity of CHD (15.9% simple, 44.8% moderate, and 39.2% complex in both groups). Patients with atrial arrhythmias had significantly worse PRO scores with respect to quality of life, perceived health status, psychological distress (ie, depression), and illness perception. A summary score that combines all PRO measures was significantly lower in patients with atrial arrhythmias (-3.3%; P = .0006). Differences in PROs were consistent across geographic regions. CONCLUSION: Atrial arrhythmias in adults with CHD are associated with an adverse impact on a broad range of PROs consistently across various geographic regions.
Authors: Chun-Wei Lu; Jou-Kou Wang; Hsiao-Ling Yang; Adrienne H Kovacs; Koen Luyckx; Francisco Javier Ruperti-Repilado; Alexander Van De Bruaene; Junko Enomoto; Maayke A Sluman; Jamie L Jackson; Paul Khairy; Stephen C Cook; Shanthi Chidambarathanu; Luis Alday; Erwin Oechslin; Katrine Eriksen; Mikael Dellborg; Malin Berghammer; Bengt Johansson; Andrew S Mackie; Samuel Menahem; Maryanne Caruana; Gruschen Veldtman; Alexandra Soufi; Susan M Fernandes; Kamila White; Edward Callus; Shelby Kutty; Silke Apers; Philip Moons Journal: J Am Heart Assoc Date: 2022-04-26 Impact factor: 6.106