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Fontan手术后成人心律失常的患病率。

Prevalence of Arrhythmia in Adults after Fontan Operation.

作者信息

Okólska Magdalena, Karkowski Grzegorz, Kuniewicz Marcin, Bednarek Jacek, Pająk Jacek, Róg Beata, Łach Jacek, Legutko Jacek, Tomkiewicz-Pająk Lidia

机构信息

Cardiological Outpatient Clinic, Department of Cardiovascular Diseases, John Paul II Hospital, 31-202 Krakow, Poland.

Department of Electrocardiology, Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, John Paul II Hospital, 31-202 Krakow, Poland.

出版信息

J Clin Med. 2022 Apr 1;11(7):1968. doi: 10.3390/jcm11071968.

Abstract

Structural, hemodynamic, and morphological cardiac changes following Fontan operation (FO) can contribute to the development of arrhythmias and conduction disorders. Sinus node dysfunction, junction rhythms, tachyarrhythmias, and ventricular arrhythmias (VAs) are some of the commonly reported arrhythmias. Only a few studies have analyzed this condition in adults after FO. This study aimed to determine the type and prevalence of arrhythmias and conduction disorders among patients who underwent FO and were under the medical surveillance of the John Paul II Hospital in Krakow. Data for the study were obtained from 50 FO patients (mean age 24 ± 5.7 years; 28 men (56%)). The median follow-up time was 4 (2-9) years. Each patient received a physical examination, an echocardiographic assessment, and a 24 h electrocardiogram assessment. Bradyarrhythmia was diagnosed in 22 patients (44%), supraventricular tachyarrhythmias in 14 patients (28%), and VAs in 6 patients (12%). Six patients required pacemaker implantation, and three required radiofrequency catheter ablation (6%). Arrythmias is a widespread clinical problem in adults after FO. It can lead to serious haemodynamic impairment, and therefore requires early diagnosis and effective treatment with the use of modern approaches, including electrotherapy methods.

摘要

Fontan手术(FO)后心脏的结构、血流动力学和形态学变化可促使心律失常和传导障碍的发生。窦房结功能障碍、交界性心律、快速性心律失常和室性心律失常(VAs)是一些常见报道的心律失常。仅有少数研究分析了成人Fontan手术后的这种情况。本研究旨在确定在克拉科夫约翰·保罗二世医院接受医学监测的Fontan手术患者中心律失常和传导障碍的类型及患病率。该研究的数据来自50例Fontan手术患者(平均年龄24±5.7岁;28例男性(56%))。中位随访时间为4(2 - 9)年。每位患者均接受了体格检查、超声心动图评估和24小时心电图评估。22例患者(44%)诊断为缓慢性心律失常,14例患者(28%)诊断为室上性快速性心律失常,6例患者(12%)诊断为室性心律失常。6例患者需要植入起搏器,3例需要射频导管消融(6%)。心律失常是Fontan手术成年患者中普遍存在的临床问题。它可导致严重的血流动力学损害,因此需要早期诊断并采用包括电疗法在内的现代方法进行有效治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ff5/9000042/3c88300793bb/jcm-11-01968-g001.jpg

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