Atrial Arrhythmias and Patient-Reported Outcomes in Adults with Congenital Heart Disease: an International Study.
Heart Rhythm. 2020 Sep 19;:
Authors: Casteigt B, Samuel M, Laplante L, Shohoudi A, Apers S, Kovacs AH, Luyckx K, Thomet C, Budts W, Enomoto J, Sluman MA, Lu CW, Jackson JL, Cook SC, Chidambarathanu S, Alday L, Eriksen K, Dellborg M, Berghammer M, Johansson B, Mackie AS, Menahem S, Caruana M, Veldtman G, Soufi A, Fernandes SM, White K, Callus E, Kutty S, Brouillette J, Moons P, Khairy P, APPROACH-IS consortium and the International Society for Adult Congenital Heart Disease (ISACHD)
BACKGROUND: Atrial arrhythmias, i.e., intra-atrial reentrant tachycardia and atrial fibrillation, are a leading cause of morbidity and hospitalizations in adults with congenital heart disease (CHD). Little is known about their effect on quality of life and other patient-reported outcomes (PROs) in adults with CHD.
OBJECTIVE: To assess the impact of atrial arrhythmias on PROs in adults with CHD and explore geographic variations.
METHODS: Associations between atrial arrhythmias and PROs were assessed in a cross-sectional study of adults with CHD from 15 countries spanning 5 continents. A propensity-based matching weight analysis was performed to compare quality of life, perceived health status, psychological distress, sense of coherence, and illness perception in patients with and without atrial arrhythmias.
RESULTS: A total of 4,028 adults with CHD were enrolled, 707 (17.6%) of whom had atrial arrhythmias. After applying matching weights, patients with and without atrial arrhythmias were comparable with regards to age (mean 40.1 versus 40.2 years), demographic variables (e.g., 52.5% versus 52.2% women), and complexity of CHD (i.e., 15.9% simple, 44.8% moderate, and 39.2% complex in both groups). Patients with atrial arrhythmias had significantly worse PRO scores with respect to quality of life, perceived health status, psychological distress (i.e., depression), and illness perception. A summary score that combines all PRO measures was significantly lower in patients with atrial arrhythmias (-3.3%, P=0.0006). Differences in PROs were consistent across geographic regions.
CONCLUSION: Atrial arrhythmias in adults with CHD are associated with an adverse impact on a broad range of PROs consistently across various geographic regions.
PMID: 32961334 [PubMed - as supplied by publisher]