Outcomes of Direct Current Cardioversion in Adults With Congenital Heart Disease

Alexander Egbe, Samuel J Asirvatham, Heidi M. Connolly, Suraj Kapa, Christopher V. Desimone, Vaibhav R. Vaidya, Abhishek J. Deshmukh, Arooj R. Khan, Christopher J. McLeod, Rowlens Melduni, Naser M. Ammash

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Few data exist on direct current cardioversion (DCCV) in adult patients with congenital heart disease (CHD). This is a retrospective case-control study of 279 adults with CHD and 279 adults without CHD (control group) who had elective DCCV for atrial arrhythmias at Mayo Clinic, 2001 to 2013. Control patients were matched by gender and arrhythmia type. The objective was to compare DCCV procedural failure (failure to terminate the presenting arrhythmia) and arrhythmia recurrence (AR). In the CHD group (mean age 55 ± 20 years; men 166 [59%]), the most common diagnosis was Fontan palliation (61; 22%). Transesophageal echocardiography was performed before DCCV in 216 patients (77%); 162 (58%) had atrial flutter, and 117 (42%) had atrial fibrillation. Procedural failure and AR between the case and the control groups were more common in the CHD group (14% vs 7%, p = 0.01) and (83% vs 66% at 60 months, p = 0.001) respectively. There were no deaths or thromboembolic complications. The multivariable risk factors for procedural failure were Fontan palliation and spontaneous echocardiographic contrast; the risk factors for AR were Fontan palliation and atrial fibrillation. When patients with Fontan palliation were excluded from the analysis, the outcome of DCCV (failure and recurrence rates) was similar for the CHD and non-CHD groups despite the age difference between the cohorts. In conclusion, the present study showed that DCCV outcomes were similar for CHD and non-CHD patients, with the exception of patients with Fontan palliation.

Original languageEnglish (US)
Pages (from-to)1468-1472
Number of pages5
JournalAmerican Journal of Cardiology
Volume119
Issue number9
DOIs
StatePublished - May 1 2017

Fingerprint

Electric Countershock
Heart Diseases
Cardiac Arrhythmias
Recurrence
Atrial Fibrillation
Age Groups
Control Groups
Atrial Flutter
Transesophageal Echocardiography
Case-Control Studies

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Outcomes of Direct Current Cardioversion in Adults With Congenital Heart Disease. / Egbe, Alexander; Asirvatham, Samuel J; Connolly, Heidi M.; Kapa, Suraj; Desimone, Christopher V.; Vaidya, Vaibhav R.; Deshmukh, Abhishek J.; Khan, Arooj R.; McLeod, Christopher J.; Melduni, Rowlens; Ammash, Naser M.

In: American Journal of Cardiology, Vol. 119, No. 9, 01.05.2017, p. 1468-1472.

Research output: Contribution to journalArticle

Egbe, A, Asirvatham, SJ, Connolly, HM, Kapa, S, Desimone, CV, Vaidya, VR, Deshmukh, AJ, Khan, AR, McLeod, CJ, Melduni, R & Ammash, NM 2017, 'Outcomes of Direct Current Cardioversion in Adults With Congenital Heart Disease', American Journal of Cardiology, vol. 119, no. 9, pp. 1468-1472. https://doi.org/10.1016/j.amjcard.2017.01.018
Egbe, Alexander ; Asirvatham, Samuel J ; Connolly, Heidi M. ; Kapa, Suraj ; Desimone, Christopher V. ; Vaidya, Vaibhav R. ; Deshmukh, Abhishek J. ; Khan, Arooj R. ; McLeod, Christopher J. ; Melduni, Rowlens ; Ammash, Naser M. / Outcomes of Direct Current Cardioversion in Adults With Congenital Heart Disease. In: American Journal of Cardiology. 2017 ; Vol. 119, No. 9. pp. 1468-1472.
@article{eb0dc5db1712422aa5d3d1a0c70998f6,
title = "Outcomes of Direct Current Cardioversion in Adults With Congenital Heart Disease",
abstract = "Few data exist on direct current cardioversion (DCCV) in adult patients with congenital heart disease (CHD). This is a retrospective case-control study of 279 adults with CHD and 279 adults without CHD (control group) who had elective DCCV for atrial arrhythmias at Mayo Clinic, 2001 to 2013. Control patients were matched by gender and arrhythmia type. The objective was to compare DCCV procedural failure (failure to terminate the presenting arrhythmia) and arrhythmia recurrence (AR). In the CHD group (mean age 55 ± 20 years; men 166 [59{\%}]), the most common diagnosis was Fontan palliation (61; 22{\%}). Transesophageal echocardiography was performed before DCCV in 216 patients (77{\%}); 162 (58{\%}) had atrial flutter, and 117 (42{\%}) had atrial fibrillation. Procedural failure and AR between the case and the control groups were more common in the CHD group (14{\%} vs 7{\%}, p = 0.01) and (83{\%} vs 66{\%} at 60 months, p = 0.001) respectively. There were no deaths or thromboembolic complications. The multivariable risk factors for procedural failure were Fontan palliation and spontaneous echocardiographic contrast; the risk factors for AR were Fontan palliation and atrial fibrillation. When patients with Fontan palliation were excluded from the analysis, the outcome of DCCV (failure and recurrence rates) was similar for the CHD and non-CHD groups despite the age difference between the cohorts. In conclusion, the present study showed that DCCV outcomes were similar for CHD and non-CHD patients, with the exception of patients with Fontan palliation.",
author = "Alexander Egbe and Asirvatham, {Samuel J} and Connolly, {Heidi M.} and Suraj Kapa and Desimone, {Christopher V.} and Vaidya, {Vaibhav R.} and Deshmukh, {Abhishek J.} and Khan, {Arooj R.} and McLeod, {Christopher J.} and Rowlens Melduni and Ammash, {Naser M.}",
year = "2017",
month = "5",
day = "1",
doi = "10.1016/j.amjcard.2017.01.018",
language = "English (US)",
volume = "119",
pages = "1468--1472",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "9",

}

TY - JOUR

T1 - Outcomes of Direct Current Cardioversion in Adults With Congenital Heart Disease

AU - Egbe, Alexander

AU - Asirvatham, Samuel J

AU - Connolly, Heidi M.

AU - Kapa, Suraj

AU - Desimone, Christopher V.

AU - Vaidya, Vaibhav R.

AU - Deshmukh, Abhishek J.

AU - Khan, Arooj R.

AU - McLeod, Christopher J.

AU - Melduni, Rowlens

AU - Ammash, Naser M.

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Few data exist on direct current cardioversion (DCCV) in adult patients with congenital heart disease (CHD). This is a retrospective case-control study of 279 adults with CHD and 279 adults without CHD (control group) who had elective DCCV for atrial arrhythmias at Mayo Clinic, 2001 to 2013. Control patients were matched by gender and arrhythmia type. The objective was to compare DCCV procedural failure (failure to terminate the presenting arrhythmia) and arrhythmia recurrence (AR). In the CHD group (mean age 55 ± 20 years; men 166 [59%]), the most common diagnosis was Fontan palliation (61; 22%). Transesophageal echocardiography was performed before DCCV in 216 patients (77%); 162 (58%) had atrial flutter, and 117 (42%) had atrial fibrillation. Procedural failure and AR between the case and the control groups were more common in the CHD group (14% vs 7%, p = 0.01) and (83% vs 66% at 60 months, p = 0.001) respectively. There were no deaths or thromboembolic complications. The multivariable risk factors for procedural failure were Fontan palliation and spontaneous echocardiographic contrast; the risk factors for AR were Fontan palliation and atrial fibrillation. When patients with Fontan palliation were excluded from the analysis, the outcome of DCCV (failure and recurrence rates) was similar for the CHD and non-CHD groups despite the age difference between the cohorts. In conclusion, the present study showed that DCCV outcomes were similar for CHD and non-CHD patients, with the exception of patients with Fontan palliation.

AB - Few data exist on direct current cardioversion (DCCV) in adult patients with congenital heart disease (CHD). This is a retrospective case-control study of 279 adults with CHD and 279 adults without CHD (control group) who had elective DCCV for atrial arrhythmias at Mayo Clinic, 2001 to 2013. Control patients were matched by gender and arrhythmia type. The objective was to compare DCCV procedural failure (failure to terminate the presenting arrhythmia) and arrhythmia recurrence (AR). In the CHD group (mean age 55 ± 20 years; men 166 [59%]), the most common diagnosis was Fontan palliation (61; 22%). Transesophageal echocardiography was performed before DCCV in 216 patients (77%); 162 (58%) had atrial flutter, and 117 (42%) had atrial fibrillation. Procedural failure and AR between the case and the control groups were more common in the CHD group (14% vs 7%, p = 0.01) and (83% vs 66% at 60 months, p = 0.001) respectively. There were no deaths or thromboembolic complications. The multivariable risk factors for procedural failure were Fontan palliation and spontaneous echocardiographic contrast; the risk factors for AR were Fontan palliation and atrial fibrillation. When patients with Fontan palliation were excluded from the analysis, the outcome of DCCV (failure and recurrence rates) was similar for the CHD and non-CHD groups despite the age difference between the cohorts. In conclusion, the present study showed that DCCV outcomes were similar for CHD and non-CHD patients, with the exception of patients with Fontan palliation.

UR - http://www.scopus.com/inward/record.url?scp=85014077155&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85014077155&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2017.01.018

DO - 10.1016/j.amjcard.2017.01.018

M3 - Article

C2 - 28262200

AN - SCOPUS:85014077155

VL - 119

SP - 1468

EP - 1472

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 9

ER -