Time Course of Atrial Fibrillation in Patients With Congenital Heart Defects.

Circ Arrhythm Electrophysiol. 2015 Oct;8(5):1065-72. doi: 10.1161/CIRCEP.115.003272. Epub 2015 Aug 14.

Time Course of Atrial Fibrillation in Patients With Congenital Heart Defects.

Teuwen CP1Ramdjan TT1Götte M1Brundel BJ1Evertz R1Vriend JW1Molhoek SG1Dorman HG1van Opstal JM1Konings TC1van der Voort P1,Delacretaz E1Houck C1Yaksh A1Jansz LJ1Witsenburg M1Roos-Hesselink JW1Triedman JK1Bogers AJ1de Groot NM2.

Comment by A. Sami Chaouki


In this study, Teuwen and colleagues sought to investigate the age of onset and initial treatment of atrial fibrillation, coexistence of atrial tachyarrhythmia, and progression of paroxysmal to persistent/permanent atrial fibrillation.  Using a multi-institutional cohort, the group identified 199 patients with different congenital heart disease and found that atrial fibrillation developed at 49 +/- 17 years of age, similar to the findings in the Rotterdam and Framingham studies; however, most patients with more complex defects presented with atrial fibrillation at under 40 years of age.  Atrial tachyarrhythmias coexisted in 33% of patients.  In 65% of those patients, atrial arrhythmias preceded AF and in the remainder was diagnosed subsequently.  26% of patients with AF progressed to persistent/permanent AF; this was despite initiation of antiarrhythmic therapy; this was notably high in the ASD sub-population.  8% of patients had a cerebrovascular event before presentation with AF and 5% had them after initial presentation.