Atrial Fibrillation Therapy and Heart Failure Hospitalization in Adults With Tetralogy of Fallot

Alexander Egbe, William R. Miranda, Naser M. Ammash, Sindhura Ananthaneni, Harigopal Sandhyavenu, Mohamed Farouk Abdelsamid, Vidhushei Yogeswaran, Suraj Kapa, Ayotola Fatola, Srikanth Kothapalli, Heidi M. Connolly

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: This study hypothesized that atrial fibrillation was associated with heart failure (HF) hospitalization, and that patients who received rhythm control therapy had a lower incidence of HF hospitalization and mortality. Background: Atrial fibrillation is a known risk factor for HF hospitalization and mortality in patients with acquired heart disease. Although atrial arrhythmias are common in adults with tetralogy of Fallot (TOF), data about prevalence and outcomes of therapy for atrial fibrillation are very limited. Methods: The MACHD (Mayo Adult Congenital Heart Disease) database was queried for adults with repaired TOF and documented atrial fibrillation from 1990 to 2017. Primary endpoint was HF hospitalization defined as admission for volume overload (pulmonary congestion and/or peripheral edema) requiring intravenous diuretics. Secondary endpoint was the effect of rhythm control therapy on HF hospitalization and all-cause mortality. Patients were divided into rhythm control and rate control groups based on the therapy initiated at the time of arrhythmia diagnosis. Results: Of 415 patients, 27 (7%) had 42 HF hospitalizations. Of these 415 patients, 88 (21%) had atrial fibrillation at age 49 ± 13 years. Atrial fibrillation was an independent risk factor for HF hospitalization (adjusted hazard ratio: 2.67; 95% confidence interval: 1.04 to 7.34; p = 0.045). The 88 patients were divided into the rhythm control group (n = 61, 69%) and the rate control group (n = 27, 31%). The rate control group had higher unadjusted annual incidence of HF hospitalization (13% vs. 3%; p = 0.001) and all-cause mortality (11% vs. 4%; p = 0.002). Conclusions: Atrial fibrillation was a risk factor for HF hospitalization and mortality in TOF patients, and rhythm control therapy was protective against these adverse events.

Original languageEnglish (US)
Pages (from-to)618-625
Number of pages8
JournalJACC: Clinical Electrophysiology
Volume5
Issue number5
DOIs
StatePublished - May 1 2019

Fingerprint

Tetralogy of Fallot
Atrial Fibrillation
Hospitalization
Heart Failure
Mortality
Control Groups
Therapeutics
Cardiac Arrhythmias
Heart Diseases
Incidence
Diuretics
Edema
Databases
Confidence Intervals
Lung

Keywords

  • atrial fibrillation
  • heart failure hospitalization
  • mortality
  • tetralogy of Fallot

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Egbe, A., Miranda, W. R., Ammash, N. M., Ananthaneni, S., Sandhyavenu, H., Farouk Abdelsamid, M., ... Connolly, H. M. (2019). Atrial Fibrillation Therapy and Heart Failure Hospitalization in Adults With Tetralogy of Fallot. JACC: Clinical Electrophysiology, 5(5), 618-625. https://doi.org/10.1016/j.jacep.2019.01.005

Atrial Fibrillation Therapy and Heart Failure Hospitalization in Adults With Tetralogy of Fallot. / Egbe, Alexander; Miranda, William R.; Ammash, Naser M.; Ananthaneni, Sindhura; Sandhyavenu, Harigopal; Farouk Abdelsamid, Mohamed; Yogeswaran, Vidhushei; Kapa, Suraj; Fatola, Ayotola; Kothapalli, Srikanth; Connolly, Heidi M.

In: JACC: Clinical Electrophysiology, Vol. 5, No. 5, 01.05.2019, p. 618-625.

Research output: Contribution to journalArticle

Egbe, A, Miranda, WR, Ammash, NM, Ananthaneni, S, Sandhyavenu, H, Farouk Abdelsamid, M, Yogeswaran, V, Kapa, S, Fatola, A, Kothapalli, S & Connolly, HM 2019, 'Atrial Fibrillation Therapy and Heart Failure Hospitalization in Adults With Tetralogy of Fallot', JACC: Clinical Electrophysiology, vol. 5, no. 5, pp. 618-625. https://doi.org/10.1016/j.jacep.2019.01.005
Egbe, Alexander ; Miranda, William R. ; Ammash, Naser M. ; Ananthaneni, Sindhura ; Sandhyavenu, Harigopal ; Farouk Abdelsamid, Mohamed ; Yogeswaran, Vidhushei ; Kapa, Suraj ; Fatola, Ayotola ; Kothapalli, Srikanth ; Connolly, Heidi M. / Atrial Fibrillation Therapy and Heart Failure Hospitalization in Adults With Tetralogy of Fallot. In: JACC: Clinical Electrophysiology. 2019 ; Vol. 5, No. 5. pp. 618-625.
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abstract = "Objectives: This study hypothesized that atrial fibrillation was associated with heart failure (HF) hospitalization, and that patients who received rhythm control therapy had a lower incidence of HF hospitalization and mortality. Background: Atrial fibrillation is a known risk factor for HF hospitalization and mortality in patients with acquired heart disease. Although atrial arrhythmias are common in adults with tetralogy of Fallot (TOF), data about prevalence and outcomes of therapy for atrial fibrillation are very limited. Methods: The MACHD (Mayo Adult Congenital Heart Disease) database was queried for adults with repaired TOF and documented atrial fibrillation from 1990 to 2017. Primary endpoint was HF hospitalization defined as admission for volume overload (pulmonary congestion and/or peripheral edema) requiring intravenous diuretics. Secondary endpoint was the effect of rhythm control therapy on HF hospitalization and all-cause mortality. Patients were divided into rhythm control and rate control groups based on the therapy initiated at the time of arrhythmia diagnosis. Results: Of 415 patients, 27 (7{\%}) had 42 HF hospitalizations. Of these 415 patients, 88 (21{\%}) had atrial fibrillation at age 49 ± 13 years. Atrial fibrillation was an independent risk factor for HF hospitalization (adjusted hazard ratio: 2.67; 95{\%} confidence interval: 1.04 to 7.34; p = 0.045). The 88 patients were divided into the rhythm control group (n = 61, 69{\%}) and the rate control group (n = 27, 31{\%}). The rate control group had higher unadjusted annual incidence of HF hospitalization (13{\%} vs. 3{\%}; p = 0.001) and all-cause mortality (11{\%} vs. 4{\%}; p = 0.002). Conclusions: Atrial fibrillation was a risk factor for HF hospitalization and mortality in TOF patients, and rhythm control therapy was protective against these adverse events.",
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AU - Egbe, Alexander

AU - Miranda, William R.

AU - Ammash, Naser M.

AU - Ananthaneni, Sindhura

AU - Sandhyavenu, Harigopal

AU - Farouk Abdelsamid, Mohamed

AU - Yogeswaran, Vidhushei

AU - Kapa, Suraj

AU - Fatola, Ayotola

AU - Kothapalli, Srikanth

AU - Connolly, Heidi M.

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N2 - Objectives: This study hypothesized that atrial fibrillation was associated with heart failure (HF) hospitalization, and that patients who received rhythm control therapy had a lower incidence of HF hospitalization and mortality. Background: Atrial fibrillation is a known risk factor for HF hospitalization and mortality in patients with acquired heart disease. Although atrial arrhythmias are common in adults with tetralogy of Fallot (TOF), data about prevalence and outcomes of therapy for atrial fibrillation are very limited. Methods: The MACHD (Mayo Adult Congenital Heart Disease) database was queried for adults with repaired TOF and documented atrial fibrillation from 1990 to 2017. Primary endpoint was HF hospitalization defined as admission for volume overload (pulmonary congestion and/or peripheral edema) requiring intravenous diuretics. Secondary endpoint was the effect of rhythm control therapy on HF hospitalization and all-cause mortality. Patients were divided into rhythm control and rate control groups based on the therapy initiated at the time of arrhythmia diagnosis. Results: Of 415 patients, 27 (7%) had 42 HF hospitalizations. Of these 415 patients, 88 (21%) had atrial fibrillation at age 49 ± 13 years. Atrial fibrillation was an independent risk factor for HF hospitalization (adjusted hazard ratio: 2.67; 95% confidence interval: 1.04 to 7.34; p = 0.045). The 88 patients were divided into the rhythm control group (n = 61, 69%) and the rate control group (n = 27, 31%). The rate control group had higher unadjusted annual incidence of HF hospitalization (13% vs. 3%; p = 0.001) and all-cause mortality (11% vs. 4%; p = 0.002). Conclusions: Atrial fibrillation was a risk factor for HF hospitalization and mortality in TOF patients, and rhythm control therapy was protective against these adverse events.

AB - Objectives: This study hypothesized that atrial fibrillation was associated with heart failure (HF) hospitalization, and that patients who received rhythm control therapy had a lower incidence of HF hospitalization and mortality. Background: Atrial fibrillation is a known risk factor for HF hospitalization and mortality in patients with acquired heart disease. Although atrial arrhythmias are common in adults with tetralogy of Fallot (TOF), data about prevalence and outcomes of therapy for atrial fibrillation are very limited. Methods: The MACHD (Mayo Adult Congenital Heart Disease) database was queried for adults with repaired TOF and documented atrial fibrillation from 1990 to 2017. Primary endpoint was HF hospitalization defined as admission for volume overload (pulmonary congestion and/or peripheral edema) requiring intravenous diuretics. Secondary endpoint was the effect of rhythm control therapy on HF hospitalization and all-cause mortality. Patients were divided into rhythm control and rate control groups based on the therapy initiated at the time of arrhythmia diagnosis. Results: Of 415 patients, 27 (7%) had 42 HF hospitalizations. Of these 415 patients, 88 (21%) had atrial fibrillation at age 49 ± 13 years. Atrial fibrillation was an independent risk factor for HF hospitalization (adjusted hazard ratio: 2.67; 95% confidence interval: 1.04 to 7.34; p = 0.045). The 88 patients were divided into the rhythm control group (n = 61, 69%) and the rate control group (n = 27, 31%). The rate control group had higher unadjusted annual incidence of HF hospitalization (13% vs. 3%; p = 0.001) and all-cause mortality (11% vs. 4%; p = 0.002). Conclusions: Atrial fibrillation was a risk factor for HF hospitalization and mortality in TOF patients, and rhythm control therapy was protective against these adverse events.

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KW - mortality

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