Journal article
Follow-Up of a Prospective Surgical Strategy to Prevent Intra-Atrial Reentrant Tachycardia After the Fontan Operation
Circulation. Arrhythmia and electrophysiology, Vol.9(12), pp.e004478-e004478
12/2016
DOI: 10.1161/CIRCEP.116.004478
PMCID: PMC5166610
PMID: 27979912
Abstract
Intra-atrial reentrant tachycardia (IART) after the Fontan operation had an early reported incidence of 10% to 35% during early and intermediate follow-up and posed substantial management challenges.
To reduce the incidence of IART after the Fontan procedure, we performed a randomized, double-blind study to evaluate the impact of an incision in the right atrium joining the lateral tunnel suture line and the tricuspid valve annulus. Between March 1998 and September 2003, 134 subjects (median age: 1.8 years; range: 1.3-5.2 years; 91 men) were randomly assigned to receive the incision. All 134 patients had a form of single ventricle pathological anatomy. The clinical course, electrocardiograms, and Holter monitoring were available for review in 114 subjects at a median of 8.2-year follow-up (range: 0.9-11.9 years). There were 2 late deaths, neither subject had IART. The combined incidence of sustained IART was 3.5% (4/114). There was no difference in the occurrence of sustained IART between those subjects receiving the incision and those who did not (2 in each group) during follow-up. No patients of either group experienced short-term complications.
Despite the fact that the primary outcome of this trial was not reached, the most significant finding was that with current management, the incidence of IART is considerably lower than the early retrospective, observational studies suggested.
Details
- Title: Subtitle
- Follow-Up of a Prospective Surgical Strategy to Prevent Intra-Atrial Reentrant Tachycardia After the Fontan Operation
- Creators
- Ian H Law - From the Division of Pediatric Cardiology, Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City (I.H.L.); and Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases (O.A., D.J.B., S.Y., M.D.) and Department of Cardiac Surgery (E.L.B., R.G.O.), University of Michigan Medical School, Ann ArborOsman Alam - From the Division of Pediatric Cardiology, Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City (I.H.L.); and Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases (O.A., D.J.B., S.Y., M.D.) and Department of Cardiac Surgery (E.L.B., R.G.O.), University of Michigan Medical School, Ann ArborEdward L Bove - From the Division of Pediatric Cardiology, Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City (I.H.L.); and Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases (O.A., D.J.B., S.Y., M.D.) and Department of Cardiac Surgery (E.L.B., R.G.O.), University of Michigan Medical School, Ann ArborRichard G Ohye - From the Division of Pediatric Cardiology, Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City (I.H.L.); and Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases (O.A., D.J.B., S.Y., M.D.) and Department of Cardiac Surgery (E.L.B., R.G.O.), University of Michigan Medical School, Ann ArborDavid J Bradley - From the Division of Pediatric Cardiology, Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City (I.H.L.); and Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases (O.A., D.J.B., S.Y., M.D.) and Department of Cardiac Surgery (E.L.B., R.G.O.), University of Michigan Medical School, Ann ArborSunkyung Yu - From the Division of Pediatric Cardiology, Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City (I.H.L.); and Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases (O.A., D.J.B., S.Y., M.D.) and Department of Cardiac Surgery (E.L.B., R.G.O.), University of Michigan Medical School, Ann ArborMacdonald Dick II - From the Division of Pediatric Cardiology, Department of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City (I.H.L.); and Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases (O.A., D.J.B., S.Y., M.D.) and Department of Cardiac Surgery (E.L.B., R.G.O.), University of Michigan Medical School, Ann Arbor. mdick@umich.edu
- Resource Type
- Journal article
- Publication Details
- Circulation. Arrhythmia and electrophysiology, Vol.9(12), pp.e004478-e004478
- DOI
- 10.1161/CIRCEP.116.004478
- PMID
- 27979912
- PMCID
- PMC5166610
- ISSN
- 1941-3149
- eISSN
- 1941-3084
- Grant note
- M01 RR000042 / NCRR NIH HHS
- Language
- English
- Date published
- 12/2016
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics
- Record Identifier
- 9984093327502771
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