Predictors of of arrythmia in adult patients with Ebstein anomaly

• Published in: European heart journal Vol. 43; no. Supplement_2
• Main Authors: Wals Rodriguez, A J, Gallego, P, Pijuan Domenech, A, Rodriguez Puras, M J, Miranda Barrio, B, Gordon Ramirez, B, Ladron Abia, R, Gonzalez Fernandez, V, Dos Subira, L
• Format: Journal Article
• Language: English
• Published: 03.10.2022
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehac544.1844

Abstract Objectives The objective of this study was to evaluate the incidence and risk factors for arrhyhthmias in adult patients with Ebstein anomaly (EA). Methods Retrospective observational study of a multicenter cohort of 123 adult patients with EA. Demographic, clinical and echocardiography data at their first visit at the Adult Congenital Heart Disease Unit were collected. Free-event survival was assessed with Kaplan Meier curves and differences between groups using the log-rank test. Predictors of arrythmia were assessed using Cox regression analysis. Results Median follow up (FU) was 6 (IQ 2–12) years and the median age at the end of FU was 47 (IQ 33–60) years. 61.8% (n=76) were women and 68 patients (55%) had associated atrial septal defects. A total of 43 patients (34%) were repaired and 11 (8.9%) required reoperation. During FU 40 patients (32.5%) had supraventricular arrhythmias (SA), mainly atrial flutter (n=19; 15.6%) and atrial fibrillation (n=14; 11.5%); 12 patients (9.8%) developed high-grade atrio-ventricular block (AVB). In the multivariate analysis, the baseline variables associated with the appearance of SA were history of cyanosis (HR: 2.269 (1.104–4.666); p=0.026) and NYHA functional class ≥ II at baseline (HR: 2.620 (CI: 1.062–6.465); p=0.037). For high-grade AVB, the associated variable was tricuspid valve implant during FU (HR: 7.993 (CI: 1.396–45.770); p=0.020). Conclusions Arrhythmias, particularly SA, are a common complication in adult patients with EA. Patients with a NYHA functional class ≥ II at baseline and those exposed to cyanosis are more prone to develop SA during FU, whereas patients requiring tricuspid valve implant are at increased risk of developing high-degree AVB. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Hospital Vall d'HebronHospital Univertsitario Virgen del Rocío