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Atrial arrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy: Prevalence, echocardiographic predictors, and treatment
Univ Calif San Francisco, CA 94143 USA.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
Univ Calif San Francisco, CA 94143 USA.
Univ Calif San Francisco, CA 94143 USA.
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2019 (English)In: Cardiovascular Electrophysiology, ISSN 1045-3873, E-ISSN 1540-8167Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction

The clinical role of atrial arrhythmias (AA) in arrhythmogenic right ventricular cardiomyopathy (ARVC) and the echocardiographic variables that predict them are not well defined. We describe the prevalence, types, echocardiographic predictors, and management of AA in patients with ARVC.

Methods

We retrospectively evaluated medical records of 117 patients with definite ARVC (2010 Task Force Criteria) from two tertiary care centers. We identified those patients with sustained AA (>30 seconds), including atrial fibrillation (AF), atrial flutter (AFL), and atrial tachycardia (AT). We collected demographic, genetic, and clinical data. The median follow‐up was 3.4 years (interquartile range = 2.0‐5.7).

Results

Total 26 patients (22%) had one or more types of AA: AF (n = 19), AFL (n = 9), and AT (n = 8). We performed genetic testing on 84 patients with ARVC (71.8%). Two patients with AA (8%) had peripheral emboli, and one patient (4%) suffered inappropriate implantable cardioverter‐defibrillator shock. We performed catheter ablation of AA in eight patients (31%), with no procedural complications. Right atrial area and left atrial volume index were independently associated with increased odds of AA; odds ratio (OR), 1.1 (95% confidence interval [CI]:1.02‐1.16) (P = .01) and OR, 1.1 (95% CI:1.03‐1.15) (P = .003), respectively. An increase in tricuspid annular plane peak systolic excursion was independently associated with reduced odds; OR, 0.3 (95% CI: 0.1‐0.94) (P = .003).

Conclusions

Atrial arrhythmias (AA) are common in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Inappropriate shocks and systemic emboli may be associated with AA. Atrial size and right ventricular dysfunction may help identify patients with ARVC at increased odds of AA.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2019.
Keywords [en]
arrhythmogenic right ventricular cardiomyopathy; atrial arrhythmias; atrial fibrillation; atrial flutter
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:liu:diva-159891DOI: 10.1111/jce.14069ISI: 000480365200001PubMedID: 31310380Scopus ID: 2-s2.0-85069818359OAI: oai:DiVA.org:liu-159891DiVA, id: diva2:1346085
Available from: 2019-08-27 Created: 2019-08-27 Last updated: 2019-09-02Bibliographically approved

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Åström-Aneq, Meriam
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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Clinical Physiology in Linköping
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