Modern Incidence of Complete Heart Block in Patients with L-looped Ventricles: Does Univentricular Status Matter?

Simmons, Mark A.; Rollinson, Nancy; Fishberger, Steven B.; Li, Qin; Fahey, John T.; Elder, Robert W.

doi:10.1111/chd.12279

Cited by 21 publications

(6 citation statements)

References 12 publications

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“…As reported previously, depending on the alterations in the conduction system, there is an equal risk for development of spontaneous complete AVB in both single‐ and two‐ventricle patients . In the present study, none of the single‐ventricle patients developed perioperative complete AVB.…”

Section: Discussionsupporting

confidence: 77%

See 1 more Smart Citation

Rhythm disturbances and treatment strategies in children with congenitally corrected transposition of the great arteries

Kaşar

Ayyıldız

Şahin

et al. 2018

Congenital Heart Disease

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Group I (n = 53, 82%) consisted of patients with significant associated lesions, and Group II (n = 12, 18%) consisted of those with minor or no associated lesions (isolated ccTGA). Rhythm abnormalities were diagnosed in 22 (34%) of the patients based on initial ECG findings and Holter ECG recordings. Eleven (17%) of these patients had atrioventricular (AV) block of different degrees, and the other 11 (17%) had supraventricular arrhythmia (SVA). The median follow-up was 49 months (range, 9-89 months), and the rhythm remained normal in 26 (42%) of the patients. Three patients died on follow-up. Of 40 patients with normal initial findings, nine required pacemaker implantation due to complete heart block, and SVA developed in seven patients on follow-up. No ventricular tachycardia was seen initially or on follow-up. Ablation was performed in four patients. During the follow-up period, pacemakers were implanted in 12 (23%) of patients in Group I and 4 (33%) of patients in Group II due to complete heart block. Cardiac resynchronization therapy (CRT) was performed in four patients due to systemic ventricular dysfunction. Notably, all four of these patients had a pacemaker implanted postoperatively.

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Section: Discussionsupporting

confidence: 77%

“…As reported previously, depending on the alterations in the conduction system, there is an equal risk for development of spontaneous complete AVB in both single-and two-ventricle patients. 17 In the pres- ccTGA. 19 They concluded that were only a few documented cases of ventricular tachycardia in patients with ccTGA.…”

mentioning

confidence: 99%

Rhythm disturbances and treatment strategies in children with congenitally corrected transposition of the great arteries

Kaşar

Ayyıldız

Şahin

et al. 2018

Congenital Heart Disease

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show abstract

“…The natural incidence of complete heart block in ccTGA is approximately 1% to 2% per 100 patient-years. 16 The management of pacing is an integral part of management of ccTGA. Summarized details of pacing systems are provided in Table E2.…”

Section: Timementioning

confidence: 99%

Long-term results of anatomic correction for congenitally corrected transposition of the great arteries: A 19-year experience

Lee

Zannino

Davis

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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Anatomic correction is a surgical challenge. It provides excellent functional outcomes in survivors with a significant need for reoperation and a definite risk of death or transplantation. Normal LV function should be expected in most patients. LV dysfunction was not linked to PAB or pacemaker requirement but surgery without LV training had better long-term LV function. The Shumacker modification provided stable venous pathways. Iatrogenic atrioventricular block remains a challenge.

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“…During the Fontan operation, unipolar epicardial leads were placed on the right atrial appendage and right ventricle as a preemptive measure, given the high risk of AV nodal block in patients with L-transposition. 3 This patient did well clinically, and was without need for cardiac pacing until age 23 years, when progressive AV nodal block was discovered. Given the complex anatomy of this patient's initial CHD and corrective surgeries, the previously abandoned epicardial leads were visualized with fluoroscopy, dissected out from the upper abdominal wall, uncapped, and attached to a new abdominal generator, leading to successful restoration of AV synchrony ( Table 1 ).…”

Section: Case Reportsmentioning

confidence: 80%

Modern Incidence of Complete Heart Block in Patients with L-looped Ventricles: Does Univentricular Status Matter?

Abstract: All patients with L-transposition of the great arteries have similar risk of spontaneous complete heart block and should be routinely screened for this complication.

Cited by 21 publications

References 12 publications

Rhythm disturbances and treatment strategies in children with congenitally corrected transposition of the great arteries

Rhythm disturbances and treatment strategies in children with congenitally corrected transposition of the great arteries

Long-term results of anatomic correction for congenitally corrected transposition of the great arteries: A 19-year experience

Old but not forgotten: Creative use of abandoned epicardial leads after more than 2 decades

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