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Pacemaker treatment after Fontan surgery-A Swedish national study.
- Source :
-
Congenital heart disease [Congenit Heart Dis] 2019 Jul; Vol. 14 (4), pp. 582-589. Date of Electronic Publication: 2019 Mar 18. - Publication Year :
- 2019
-
Abstract
- Objective: Fontan surgery is performed in children with univentricular heart defects. Previous data regarding permanent pacemaker implantation frequency and indications in Fontan patients are limited and conflicting. We examined the prevalence of and risk factors for pacemaker treatment in a consecutive national cohort of patients after Fontan surgery in Sweden.<br />Methods: We retrospectively reviewed all Swedish patients who underwent Fontan surgery from 1982 to 2017 (n = 599).<br />Results: After a mean follow-up of 12.2 years, 13% (78/599) of the patients with Fontan circulation had received pacemakers. Patients operated with the extracardiac conduit (EC) type of total cavopulmonary connection had a significantly lower prevalence of pacemaker implantation (6%) than patients with lateral tunnel (LT; 17%). Mortality did not differ between patients with (8%) and without pacemaker (5%). The most common pacemaker indication was sinus node dysfunction (SND) (64%). Pacemaker implantation due to SND was less common among patients with EC. Pacemaker implantation was significantly more common in patients with mitral atresia (MA; 44%), double outlet right ventricle (DORV; 24%) and double inlet left ventricle (DILV; 20%). In contrast, patients with pulmonary atresia with intact ventricular septum and hypoplastic left heart syndrome were significantly less likely to receive a pacemaker (3% and 6%, respectively).<br />Conclusions: Thirteen percent of Fontan patients received a permanent pacemaker, most frequently due to SND. EC was associated with a significantly lower prevalence of pacemaker than LT. Permanent pacemaker was more common in patients with MA, DORV, and DILV.<br /> (© 2019 Wiley Periodicals, Inc.)
- Subjects :
- Adolescent
Adult
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Incidence
Infant
Male
Postoperative Complications epidemiology
Postoperative Complications etiology
Retrospective Studies
Sick Sinus Syndrome epidemiology
Sick Sinus Syndrome etiology
Sweden epidemiology
Treatment Outcome
Young Adult
Fontan Procedure adverse effects
Forecasting
Heart Defects, Congenital surgery
Pacemaker, Artificial
Postoperative Complications therapy
Sick Sinus Syndrome therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1747-0803
- Volume :
- 14
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Congenital heart disease
- Publication Type :
- Academic Journal
- Accession number :
- 30883035
- Full Text :
- https://doi.org/10.1111/chd.12766