Risk factors for atrial arrhythmia recurrence after atrial arrhythmia surgery with pulmonary valve replacementCentral MessagePerspective
Objectives: Atrial arrhythmias are a significant cause of late morbidity and mortality in patients after tetralogy of Fallot repair. However, reports on their recurrence following atrial arrhythmia surgery are limited. We aimed to identify the risk factors for atrial arrhythmia recurrence after pulm...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-06-01
|
| Series: | JTCVS Open |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S266627362300102X |
| _version_ | 1797796092061941760 |
|---|---|
| author | Yuji Tominaga, MD Masaki Taira, MD Takuji Watanabe, MD Moyu Hasegawa, MD Ryoto Sakaniwa, MD, MPH, PhD Daisuke Yoshioka, MD, PhD Kazuo Shimamura, MD, PhD Takayoshi Ueno, MD, PhD Shigeru Miyagawa, MD, PhD |
| author_facet | Yuji Tominaga, MD Masaki Taira, MD Takuji Watanabe, MD Moyu Hasegawa, MD Ryoto Sakaniwa, MD, MPH, PhD Daisuke Yoshioka, MD, PhD Kazuo Shimamura, MD, PhD Takayoshi Ueno, MD, PhD Shigeru Miyagawa, MD, PhD |
| author_sort | Yuji Tominaga, MD |
| collection | DOAJ |
| description | Objectives: Atrial arrhythmias are a significant cause of late morbidity and mortality in patients after tetralogy of Fallot repair. However, reports on their recurrence following atrial arrhythmia surgery are limited. We aimed to identify the risk factors for atrial arrhythmia recurrence after pulmonary valve replacement (PVR) and arrhythmia surgery. Methods: We reviewed 74 patients with repaired tetralogy of Fallot who underwent PVR for pulmonary insufficiency at our hospital between 2003 and 2021. Twenty-two patients (mean age, 39 years) underwent PVR and atrial arrhythmia surgery. A modified Cox-maze III was performed in 6 patients with chronic atrial fibrillation, and a right-sided maze was performed in 12 with paroxysmal atrial fibrillation, 3 with atrial flutter, and 1 with atrial tachycardia. Atrial arrhythmia recurrence was defined as any documented sustained atrial tachyarrhythmia requiring intervention. The influence of preoperative parameters on recurrence was assessed with the Cox proportional-hazards model. Results: The median follow-up period was 9.2 years (interquartile range, 4.5-12.4). Cardiac death and redo-PVR due to prosthetic valve dysfunction were not observed. Eleven patients had atrial arrhythmia recurrence after discharge. Atrial arrhythmia recurrence-free rates were 68% at 5 years and 51% at 10 years after PVR and arrhythmia surgery. Multivariable analysis revealed that right atrial volume index (hazard ratio, 1.04; 95% confidence interval, 1.01-1.08, P = .009) was a significant risk factor for atrial arrhythmia recurrence after arrhythmia surgery and PVR. Conclusions: Preoperative right atrial volume index was associated with atrial arrhythmia recurrence, which may assist in planning the timing of atrial arrhythmia surgery and PVR. |
| first_indexed | 2024-03-13T03:27:56Z |
| format | Article |
| id | doaj.art-06806718fadd41838ad7bfd2597f9dce |
| institution | Directory Open Access Journal |
| issn | 2666-2736 |
| language | English |
| last_indexed | 2024-03-13T03:27:56Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Open |
| spelling | doaj.art-06806718fadd41838ad7bfd2597f9dce2023-06-25T04:43:49ZengElsevierJTCVS Open2666-27362023-06-0114123133Risk factors for atrial arrhythmia recurrence after atrial arrhythmia surgery with pulmonary valve replacementCentral MessagePerspectiveYuji Tominaga, MD0Masaki Taira, MD1Takuji Watanabe, MD2Moyu Hasegawa, MD3Ryoto Sakaniwa, MD, MPH, PhD4Daisuke Yoshioka, MD, PhD5Kazuo Shimamura, MD, PhD6Takayoshi Ueno, MD, PhD7Shigeru Miyagawa, MD, PhD8Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, JapanDepartment of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, Japan; Address for reprints: Masaki Taira, MD, Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-Oka, Suita, Osaka 565-0871, Japan.Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Public Health, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, JapanDepartment of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Osaka, JapanObjectives: Atrial arrhythmias are a significant cause of late morbidity and mortality in patients after tetralogy of Fallot repair. However, reports on their recurrence following atrial arrhythmia surgery are limited. We aimed to identify the risk factors for atrial arrhythmia recurrence after pulmonary valve replacement (PVR) and arrhythmia surgery. Methods: We reviewed 74 patients with repaired tetralogy of Fallot who underwent PVR for pulmonary insufficiency at our hospital between 2003 and 2021. Twenty-two patients (mean age, 39 years) underwent PVR and atrial arrhythmia surgery. A modified Cox-maze III was performed in 6 patients with chronic atrial fibrillation, and a right-sided maze was performed in 12 with paroxysmal atrial fibrillation, 3 with atrial flutter, and 1 with atrial tachycardia. Atrial arrhythmia recurrence was defined as any documented sustained atrial tachyarrhythmia requiring intervention. The influence of preoperative parameters on recurrence was assessed with the Cox proportional-hazards model. Results: The median follow-up period was 9.2 years (interquartile range, 4.5-12.4). Cardiac death and redo-PVR due to prosthetic valve dysfunction were not observed. Eleven patients had atrial arrhythmia recurrence after discharge. Atrial arrhythmia recurrence-free rates were 68% at 5 years and 51% at 10 years after PVR and arrhythmia surgery. Multivariable analysis revealed that right atrial volume index (hazard ratio, 1.04; 95% confidence interval, 1.01-1.08, P = .009) was a significant risk factor for atrial arrhythmia recurrence after arrhythmia surgery and PVR. Conclusions: Preoperative right atrial volume index was associated with atrial arrhythmia recurrence, which may assist in planning the timing of atrial arrhythmia surgery and PVR.http://www.sciencedirect.com/science/article/pii/S266627362300102Xtetralogy of Fallotatrial tachyarrhythmiamaze procedurerecurrence ratepulmonary valve replacement |
| spellingShingle | Yuji Tominaga, MD Masaki Taira, MD Takuji Watanabe, MD Moyu Hasegawa, MD Ryoto Sakaniwa, MD, MPH, PhD Daisuke Yoshioka, MD, PhD Kazuo Shimamura, MD, PhD Takayoshi Ueno, MD, PhD Shigeru Miyagawa, MD, PhD Risk factors for atrial arrhythmia recurrence after atrial arrhythmia surgery with pulmonary valve replacementCentral MessagePerspective JTCVS Open tetralogy of Fallot atrial tachyarrhythmia maze procedure recurrence rate pulmonary valve replacement |
| title | Risk factors for atrial arrhythmia recurrence after atrial arrhythmia surgery with pulmonary valve replacementCentral MessagePerspective |
| title_full | Risk factors for atrial arrhythmia recurrence after atrial arrhythmia surgery with pulmonary valve replacementCentral MessagePerspective |
| title_fullStr | Risk factors for atrial arrhythmia recurrence after atrial arrhythmia surgery with pulmonary valve replacementCentral MessagePerspective |
| title_full_unstemmed | Risk factors for atrial arrhythmia recurrence after atrial arrhythmia surgery with pulmonary valve replacementCentral MessagePerspective |
| title_short | Risk factors for atrial arrhythmia recurrence after atrial arrhythmia surgery with pulmonary valve replacementCentral MessagePerspective |
| title_sort | risk factors for atrial arrhythmia recurrence after atrial arrhythmia surgery with pulmonary valve replacementcentral messageperspective |
| topic | tetralogy of Fallot atrial tachyarrhythmia maze procedure recurrence rate pulmonary valve replacement |
| url | http://www.sciencedirect.com/science/article/pii/S266627362300102X |
| work_keys_str_mv | AT yujitominagamd riskfactorsforatrialarrhythmiarecurrenceafteratrialarrhythmiasurgerywithpulmonaryvalvereplacementcentralmessageperspective AT masakitairamd riskfactorsforatrialarrhythmiarecurrenceafteratrialarrhythmiasurgerywithpulmonaryvalvereplacementcentralmessageperspective AT takujiwatanabemd riskfactorsforatrialarrhythmiarecurrenceafteratrialarrhythmiasurgerywithpulmonaryvalvereplacementcentralmessageperspective AT moyuhasegawamd riskfactorsforatrialarrhythmiarecurrenceafteratrialarrhythmiasurgerywithpulmonaryvalvereplacementcentralmessageperspective AT ryotosakaniwamdmphphd riskfactorsforatrialarrhythmiarecurrenceafteratrialarrhythmiasurgerywithpulmonaryvalvereplacementcentralmessageperspective AT daisukeyoshiokamdphd riskfactorsforatrialarrhythmiarecurrenceafteratrialarrhythmiasurgerywithpulmonaryvalvereplacementcentralmessageperspective AT kazuoshimamuramdphd riskfactorsforatrialarrhythmiarecurrenceafteratrialarrhythmiasurgerywithpulmonaryvalvereplacementcentralmessageperspective AT takayoshiuenomdphd riskfactorsforatrialarrhythmiarecurrenceafteratrialarrhythmiasurgerywithpulmonaryvalvereplacementcentralmessageperspective AT shigerumiyagawamdphd riskfactorsforatrialarrhythmiarecurrenceafteratrialarrhythmiasurgerywithpulmonaryvalvereplacementcentralmessageperspective |