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Fontan Survivors Show Less IART Than Previously Reported

Factors associated with intra-atrial re-entrant tachycardia include paced rhythm

WEDNESDAY, Sept. 1 (HealthDay News) -- The prevalence of intra-atrial re-entrant tachycardia (IART) in a large group of survivors of the Fontan operation is lower than that reported in previous studies, and certain factors appear to be linked to development of this problem, according to research published in the Sept. 7 issue of the Journal of the American College of Cardiology.

Elizabeth A. Stephenson, M.D., of the Hospital for Sick Children in Toronto, and colleagues analyzed data from 520 patients in the Pediatric Heart Network Fontan Cross-Sectional Study, aged 6 to 18 years, who had undergone the procedure a mean 8.6 years earlier.

The researchers found supraventricular tachycardias in 9.4 percent of patients and IART in 7.3 percent. They note that the prevalence of IART was lower in this cohort than in previous studies. The risk of IART was high in the first two years after the procedure, and then reached its lowest level of risk four to six years after completion of the operation. Factors linked to time to occurrence of IART were lower functional status on the Child Health Questionnaire, paced rhythm, and the atriopulmonary connection type of procedure.

"After 15+ years of experience with entrainment mapping and electroanatomic mapping of arrhythmia circuits in patients after the Fontan procedure, we should be able to come to a better understanding of the exact elements of surgical technique that create the substrate for atrial arrhythmia, and apply this knowledge to prevent this surgical complication in the future," writes the author of an accompanying editorial.

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