Incidence, Risk Factors, and Outcomes of Atrial Arrhythmias in Adult Patients With Atrioventricular Septal Defect

2021 ◽  
Author(s):  
Etienne Jacquemart ◽  
Francis Bessière ◽  
Nicolas Combes ◽  
Magalie Ladouceur ◽  
Laurence Iserin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Adult Patients ◽  
Atrial Arrhythmias ◽  
Incidence Risk

Stroke in patients with secundum atrial septal defect and sequelae after transcatheter closure

Heart ◽  
2021 ◽  
pp. heartjnl-2021-319050
Author(s):  
Stephen J Dolgner ◽  
Zachary Louis Steinberg ◽  
Thomas K Jones ◽  
Mark Reisman ◽  
Jonathan Buber
Keyword(s):  
Risk Factors ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Lifestyle Changes ◽  
Adult Patients ◽  
Atrial Arrhythmias ◽  
Secundum Atrial Septal Defect ◽  
Eustachian Valve ◽  
Increased Risk ◽  
Asd Closure

ObjectiveTo evaluate the frequency of and risk factors for stroke as a presenting feature in adult patients with secundum atrial septal defect (ASD); rates of post-closure atrial fibrillation (AF) and stroke were also assessed.MethodsWe retrospectively reviewed adult patients who presented with an ASD between 2002 and 2018, excluding those with known atrial arrhythmias. Risk factors for stroke were identified using multivariable logistic regression. Post-closure stroke was evaluated using survival analysis stratified by the presence of post-procedure AF.ResultsOf 346 patients with ASD (median age 44 years), 34 (10%) presented with a history of stroke. Independent risk factors included elevated body mass index over 25 (OR: 18.2; 95% CI: 4.0 to 82.2; p<0.001), smoking (OR: 9.5; 95% CI: 3.8 to 23.9; p<0.001) and a prominent Eustachian valve (OR: 9.2; 95% CI: 3.4 to 25.2; p<0.001). A scoring system based on these three parameters provided robust stroke risk stratification. During a median follow-up of 12 months after closure, 12 patients (4%) experienced AF and 4 patients (1%) had a new stroke. AF was highly associated with development of stroke post-closure (p<0.001).ConclusionsIn this study population, the incidence of stroke prior to ASD closure among patients without atrial arrhythmias was 10%. Risk factors included obesity, smoking and prominent Eustachian valve anatomy. Lifestyle changes should be recommended for at-risk patients, and it may be reasonable to consider ASD closure in the absence of haemodynamic indications in patients at increased risk of stroke.

scholarly journals Incidence, risk factors and outcomes of atrial arrhythmias in adult patients with atrioventricular septal defect

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
E Jacquemart ◽  
F Bessiere ◽  
N Combes ◽  
M Ladouceur ◽  
L Iserin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adult Congenital Heart Disease ◽  
Pacemaker Implantation ◽  
Atrioventricular Septal Defect ◽  
Adult Patients ◽  
Atrial Arrhythmia ◽  
Public Institution ◽  
Right Atrial ◽  
Atrial Arrhythmias ◽  
Logistic Regression Models

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): French Federation of Cardiology Background The number of adults with atrioventricular septal defects (AVSD) is growing, with however, very few data regarding the natural history of atrial arrhythmias in this specific population. We aimed to assess the incidence, associated factors and outcomes of atrial arrhythmias among adult patients with AVSD. Methods Multicentric retrospective cohort of patients with AVSD from 3 referral centers specialized in adult congenital heart disease. Unbalanced AVSD, univentricular hearts, and Eisenmenger syndromes were excluded. Lifetime cumulative incidences of different types of atrial arrhythmia (&gt;30 seconds) were analyzed (atrial fibrillation [AF] and intra atrial reentrant tachycardia/focal atrial tachycardia [IART/FAT]). Multiple logistic regression models were used to identify risk factors for atrial arrhythmias. Results The cohort comprised of 391 patients (61.6% of women) with a mean age of 36.3 ± 16.3 years and 17.3 ± 14.2 years of follow-up after surgical repair in operated patients, including 333 (85.1%) partial/intermediate and 58 (1.0%) complete AVSD. Overall, atrial arrhythmias were documented in 98 patients (25.1%). The lifetime risks for developing atrial arrhythmia to ages 20, 40, and 60 were 3.7%, 17.6%, and 54.8%. IART/FAT was the leading arrhythmia until the age of 45 then AF surpassed IART/FAT. Age (OR = 1.4, 95%CI = 1.2-1.6 by 5 years increment), the number of cardiac surgeries (OR = 4.1, 95%CI = 2.5-6.9), left atrial dilatation (OR = 3.1, 95%CI = 1.4-6.8), right atrial dilatation (OR = 4.1, 95%CI = 1.7-10.3), and moderate or severe left AV valve regurgitation (OR = 3.7, 95%CI = 1.2-11.7) were independently associated with a higher risk of atrial arrhythmias. Patients with atrial arrhythmias more frequently had pacemaker implantation (41.8% vs. 8.5%, p &lt; 0.001), heart failure (24.5% vs 1.0%, p &lt; 0.001) and cerebrovascular accidents (11.2% vs 3.4%, p = 0.007). Conclusions The lifetime risk of atrial arrhythmias in patients with AVSD is considerable with more than half of patients who will develop an atrial arrhythmia by the age of 60. Atrial arrhythmias are associated with a significant morbidity in this population. Abstract Figure. Central Illustration AVSD

scholarly journals Incidence, risk factors and prognostic effect of imaging right ventricular involvement in patients with COVID-19: a dose–response analysis protocol for systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049866
Author(s):  
Chenghui Zhou ◽  
Baohui Lou ◽  
Hui Li ◽  
Xin Wang ◽  
Hushan Ao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Right Ventricular ◽  
Dose Response ◽  
Meta Analysis ◽  
Adult Patients ◽  
Sensitivity Analyses ◽  
Prognostic Effect ◽  
All Cause Mortality ◽  
Incidence Risk

IntroductionEmerging evidence has shown that COVID-19 infection may result in right ventricular (RV) disturbance and be associated with adverse clinical outcomes. The aim of this meta-analysis is to summarise the incidence, risk factors and the prognostic effect of imaging RV involvement in adult patients with COVID-19.MethodsA systematical search will be performed in PubMed, EMBase, ISI Knowledge via Web of Science and preprint databases (MedRxiv and BioRxiv) (until October 2021) to identify all cohort studies in adult patients with COVID-19. The primary outcome will be the incidence of RV involvement (dysfunction and/or dilation) assessed by echocardiography, CT or MRI. Secondary outcomes will include the risk factors for RV involvement and their association with all-cause mortality during hospitalisation. Additional outcomes will include the RV global or free wall longitudinal strain (RV-GLS or RV-FWLS), tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC) and RV diameter. Univariable or multivariable meta-regression and subgroup analyses will be performed for the study design and patient characteristics (especially acute or chronic pulmonary embolism and pulmonary hypertension). Sensitivity analyses will be used to assess the robustness of our results by removing each included study at one time to obtain and evaluate the remaining overall estimates of RV involvement incidence and related risk factors, association with all-cause mortality, and other RV parameters (RV-GLS or RV-FWLS, TAPSE, S’, FAC and RV diameter). Both linear and cubic spline regression models will be used to explore the dose–response relationship between different categories (>2) of RV involvement and the risk of mortality (OR or HR).Ethics and disseminationThere was no need for ethics approval for the systematic review protocol according to the Institutional Review Board/Independent Ethics Committee of Fuwai Hospital. This meta-analysis will be disseminated through a peer-reviewed journal for publication.PROSPERO registration numberCRD42021231689.

scholarly journals Thrombocytopenia in adult patients with sepsis: incidence, risk factors, and its association with clinical outcome

2013 ◽  
Vol 1 (1) ◽  
Author(s):  
Chakradhar Venkata ◽  
Rahul Kashyap ◽  
J Christopher Farmer ◽  
Bekele Afessa
Keyword(s):  
Risk Factors ◽  
Clinical Outcome ◽  
Adult Patients ◽  
Incidence Risk

Complete atrioventricular septal defect, Down syndrome, and surgical outcome: risk factors

2003 ◽  
Vol 75 (2) ◽  
pp. 412-421 ◽  
Author(s):  
Amira A Al-Hay ◽  
Stephanie J MacNeill ◽  
Magdi Yacoub ◽  
Darryl F Shore ◽  
Elliot A Shinebourne
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Surgical Outcome ◽  
Septal Defect ◽  
Atrioventricular Septal Defect ◽  
Complete Atrioventricular Septal Defect ◽  
Complete Atrioventricular

Incidence, risk factors and medical cost of peripheral intravenous catheter-related complications in hospitalised adult patients

2020 ◽  
pp. 112972982097812
Author(s):  
Congcong Liu ◽  
Lin Chen ◽  
Dong Kong ◽  
Fangfang Lyu ◽  
Linlin Luan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Insertion Site ◽  
Medical Costs ◽  
Adult Patients ◽  
Infusion Therapy ◽  
Vascular Access Devices ◽  
Surgical Department ◽  
Infiltration Rates ◽  
Tertiary Teaching ◽  
Incidence Risk

Background: Peripheral intravenous catheters (PVCs) are widely used vascular access devices for infusion therapy; however, they are associated with relatively high failure rates. This study aimed to identify the incidence, risk factors and medical costs of PVC-induced complications in adult hospitalised adult patients in China. Methods: An observational, prospective study on 1069 patients lasting 5 months was conducted at a tertiary teaching hospital. Results: Infiltration ranked first among PVC complications with an incidence of 17.8%, followed by occlusion (10.8%) and phlebitis (10.5%). Most complications in phlebitis (88.4%) and infiltration (93.7%) were Grade 1. Catheters left in for over 96 h did not show a higher incidence of complications. Patients from the surgical department were more susceptible to infiltration, phlebitis and occlusion. The 26 gauge (Ga) catheters decreased the risk of phlebitis and occlusion, whereas 24Ga catheters increased infiltration rates. Infusing irritant drugs increased phlebitis and infiltration rates. The presence of comorbidities and non-use of needleless connectors were associated with occlusion. Compared with forearm insertion, the risk of occlusion nearly doubled with the dorsum of the hand insertion and the risk of infiltration tripled with antecubital fossa insertion. Medical treatment costs for PVC complications ranged from 0.3 to 140.0 CNY. Conclusions: Infiltration is the most common PVC-related adverse event. Clinically-indicated instead of routine replacement of catheters is safe. More efforts are warranted to improve nurses’ adherence to recent guidelines in terms of insertion site selection and needleless connector utilisation to reduce medical costs associated with catheter replacement.

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