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Kakarla J, Denham NC, Ishikita A, Oechslin E, Alonso-Gonzalez R, Nair K. Risk Stratification for Sudden Cardiac Death in Repaired Tetralogy of Fallot. CJC PEDIATRIC AND CONGENITAL HEART DISEASE 2023; 2:414-425. [PMID: 38161672 PMCID: PMC10755789 DOI: 10.1016/j.cjcpc.2023.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 07/18/2023] [Indexed: 01/03/2024]
Abstract
There has been significant progress in the prevention of sudden cardiac death in repaired tetralogy of Fallot. Contemporary cohorts report greater survival attributable to improved surgical techniques, heart failure management, and proactive strategies for risk stratification and management of ventricular arrhythmias including defibrillator implantation and ablation technology. Over the last 25 years, our understanding of predictive risk factors has also improved from invasive and more limited measures to individualized risk prediction scores based on extensive demographic, imaging, electrophysiological, and functional data. Although each of these contemporary scoring systems improves prediction, there are important differences between the study cohorts, included risk factors, and imaging modalities that can significantly affect interpretation and implementation for the individual patient. In addition, accurate phenotyping of disease complexity and anatomic repair substantially modulates this risk and the mechanism of sudden death. Routine implementation of risk stratification within repaired tetralogy of Fallot management is important and directly informs primary prevention defibrillator implantation as well as consideration for proactive invasive strategies including ventricular tachycardia ablation and pulmonary valve replacement. Assessment and risk stratification by a multidisciplinary team of experts in adult congenital heart disease are crucial and critical. Although we have increased understanding, reconciliation of these complex factors for the individual patient remains challenging and often requires careful consideration and discussion with multidisciplinary teams, patients, and their families.
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Affiliation(s)
- Jayant Kakarla
- University Health Network Toronto, Peter Munk Cardiac Centre, Toronto Adult Congenital Heart Disease Program, and University of Toronto, Toronto, Ontario, Canada
| | - Nathan C. Denham
- University Health Network Toronto, Peter Munk Cardiac Centre, Toronto Adult Congenital Heart Disease Program, and University of Toronto, Toronto, Ontario, Canada
| | - Ayako Ishikita
- University Health Network Toronto, Peter Munk Cardiac Centre, Toronto Adult Congenital Heart Disease Program, and University of Toronto, Toronto, Ontario, Canada
| | - Erwin Oechslin
- University Health Network Toronto, Peter Munk Cardiac Centre, Toronto Adult Congenital Heart Disease Program, and University of Toronto, Toronto, Ontario, Canada
| | - Rafael Alonso-Gonzalez
- University Health Network Toronto, Peter Munk Cardiac Centre, Toronto Adult Congenital Heart Disease Program, and University of Toronto, Toronto, Ontario, Canada
| | - Krishnakumar Nair
- University Health Network Toronto, Peter Munk Cardiac Centre, Toronto Adult Congenital Heart Disease Program, and University of Toronto, Toronto, Ontario, Canada
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Prana Jagannatha GN, Antara IMPS, Kosasih AM, de Liyis BG, Labi NPT, Aji WC, Deantri F, Wibawa IMBC, Wibawa IBS, Adrian J. Future direction of substrate-based catheter ablation in Brugada syndrome and other inherited primary arrhythmia syndromes: Systematic review and meta-analysis. J Arrhythm 2023; 39:909-927. [PMID: 38045449 PMCID: PMC10692854 DOI: 10.1002/joa3.12947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/29/2023] [Accepted: 10/17/2023] [Indexed: 12/05/2023] Open
Abstract
Background Inherited Primary Arrhythmias Syndromes (IPAS), especially Brugada syndrome (BrS), have been associated with arrhythmogenic substrates that can be targeted through ablation. This meta-analysis evaluated the outcomes of catheter ablation (CA) in different types of IPAS based on procedural guidance and location. Methods A systematic search was conducted across multiple databases to identify studies reporting on ventricular arrhythmia (VA) events before and after CA in IPAS, including BrS, Long-QT syndrome (LQTS), Early repolarization syndrome (ERS), and Idiopathic ventricular fibrillation (IVF). The primary outcomes were VA recurrence and VA burden, evaluated through conditional subgroup analysis. Procedural data were collected as secondary outcomes. Results A total of 21 studies involving 584 IPAS patients who underwent CA were included. Following a mean follow-up duration of 33.5 months, substrate-based ablation demonstrated efficacy in reducing VA recurrence across all types of IPAS [RR 0.23; 95% CI (0.13-0.39); p < .001; I 2 = 74%]. However, activation guidance ablation was found to be effective only in IVF cases. Although recurrences still occurred, CA was successful in reducing VA burden [MD -4.70; 95% CI (-6.11-(-3.29); p < .001; I 2 = 74%]. The mean size of arrhythmogenic substrate was 15.70 cm2 [95% CI (12.34-19.99 cm2)], predominantly distributed in the epicardial right ventricular outflow tract (RVOT) in BrS cases and LQTS [Proportion 0.99; 95% CI (0.96-1.00) and Proportion 0.82; 95% CI ( 0.59-1.00), respectively]. Conclusion Substrate-based CA has demonstrated effective prevention of VA and reduction in VA burden in IPAS cases.
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Affiliation(s)
| | - I Made Putra Swi Antara
- Division of Electrophysiology and Cardiac PacingDepartment of Cardiology and Vascular Medicine, Faculty of Medicine Udayana University/Prof. dr. I.G.N.G Ngoerah General HospitalDenpasarBaliIndonesia
| | - Anastasya Maria Kosasih
- Faculty of MedicineUdayana University/Prof. dr. I.G.N.G Ngoerah General HospitalDenpasarBaliIndonesia
| | - Bryan Gervais de Liyis
- Faculty of MedicineUdayana University/Prof. dr. I.G.N.G Ngoerah General HospitalDenpasarBaliIndonesia
| | | | - Wingga Chrisna Aji
- Faculty of MedicineMuhammadiyah Yogyakarta UniversityYogyakartaIndonesia
| | - Fanny Deantri
- Faculty of MedicineUdayana University/Prof. dr. I.G.N.G Ngoerah General HospitalDenpasarBaliIndonesia
| | - I Made Bagus Cahya Wibawa
- Faculty of MedicineUdayana University/Prof. dr. I.G.N.G Ngoerah General HospitalDenpasarBaliIndonesia
| | - Ida Bagus Satriya Wibawa
- Faculty of MedicineUdayana University/Prof. dr. I.G.N.G Ngoerah General HospitalDenpasarBaliIndonesia
| | - Jonathan Adrian
- Faculty of MedicineUdayana University/Prof. dr. I.G.N.G Ngoerah General HospitalDenpasarBaliIndonesia
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Ladouceur M, Van De Bruaene A, Kauling R, Budts W, Roos-Hesselink J, Villagrá Albert S, Sanchez Perez I, Sarubbi B, Fusco F, Gallego P, Rodriguez-Puras MJ, Bouchardy J, Blanche C, Rutz T, Prokselj K, Labombarda F, Iserin L, Wong T, Gatzoulis MA. A new score for life-threatening ventricular arrhythmias and sudden cardiac death in adults with transposition of the great arteries and a systemic right ventricle. Eur Heart J 2022; 43:2685-2694. [PMID: 35673927 DOI: 10.1093/eurheartj/ehac288] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 04/18/2022] [Accepted: 05/18/2022] [Indexed: 01/18/2023] Open
Abstract
AIMS To investigate the incidence of major adverse ventricular arrhythmias and related events (MAREs) and to develop a stratification tool predicting MAREs in adults with a systemic right ventricle (sRV). METHODS AND RESULTS In a multicentre approach, all adults (≥16 years old) with a sRV undergoing follow-up between 2000 and 2018 were identified. The incidence of MAREs, defined as sudden cardiac death, sustained ventricular tachycardia, and appropriate implantable cardioverter-defibrillator (ICD) therapy, was analysed. The association of MAREs with clinical, electrical, and echocardiographic parameters was evaluated. A total of 1184 patients (median age 27.1 years; interquartile range 19.9-34.9 years; 59% male; 70% with atrial switch repair for D-transposition of the great arteries) were included. The incidence of MAREs was 6.3 per 1000 patient-years. On multivariate analysis, age, history of heart failure, syncope, QRS duration, severe sRV dysfunction and at least moderate left ventricular outflow tract obstruction were retained in the final model with a C-index of 0.78 [95% confidence interval (CI) 0.72-0.83] and a calibration slope of 0.93 (95% CI 0.64-1.21). For every five ICDs implanted in patients with a 5-year MARE risk >10%, one patient may potentially be spared from a MARE. CONCLUSION Sudden cardiac death remains a devastating cause of death in a contemporary adult cohort with a sRV. A prediction model based on clinical, electrocardiographic, and echocardiographic parameters was devised to estimate MARE risk and to identify high-risk patients who may benefit from primary prevention ICD implantation.
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Affiliation(s)
- Magalie Ladouceur
- Centre de référence des Malformations Cardiaques Congénitales Complexes, M3C, Adult Congenital Heart Disease Unit, Hôpital Européen Georges Pompidou, APHP, Paris Cité University, Paris 75015, France.,Centre de Recherche Cardiovasculaire de Paris, INSERM U970, 20 rue Leblanc, Paris 75015, France
| | - Alexander Van De Bruaene
- Division of Congenital and Structural Cardiology, University Hospitals Leuven, and Catholic University Leuven, Leuven, Belgium
| | - Robert Kauling
- Department of Cardiology, Thoraxcenter, ErasmusMC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Werner Budts
- Division of Congenital and Structural Cardiology, University Hospitals Leuven, and Catholic University Leuven, Leuven, Belgium
| | - Jolien Roos-Hesselink
- Department of Cardiology, Thoraxcenter, ErasmusMC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | | | - Berardo Sarubbi
- Adult Congenital Heart Disease Unit, AORN dei Colli-Monaldi Hospital, Naples, Italy
| | - Flavia Fusco
- Adult Congenital Heart Disease Unit, AORN dei Colli-Monaldi Hospital, Naples, Italy
| | - Pastora Gallego
- Adult Congenital Heart Disease Unit, Department of Cardiology, Hospital Universitario Virgen del Rocio, Instituto de BioMedicina de Sevilla (IBIS) and CIBERCV, Sevilla, Spain
| | - Maria-Jose Rodriguez-Puras
- Adult Congenital Heart Disease Unit, Department of Cardiology, Hospital Universitario Virgen del Rocio, Instituto de BioMedicina de Sevilla (IBIS) and CIBERCV, Sevilla, Spain
| | - Judith Bouchardy
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Service de Cardiologie, Département de Médecine, Hôpitaux Universitaires de Genève, 1205 Genève, Switzerland
| | - Coralie Blanche
- Service de Cardiologie, Département de Médecine, Hôpitaux Universitaires de Genève, 1205 Genève, Switzerland
| | - Tobias Rutz
- Service of Cardiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Katja Prokselj
- Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Fabien Labombarda
- Cardiology Department, CHU de Caen, Caen, France.,UNICAEN, EA 4650 Caen, France
| | - Laurence Iserin
- Centre de référence des Malformations Cardiaques Congénitales Complexes, M3C, Adult Congenital Heart Disease Unit, Hôpital Européen Georges Pompidou, APHP, Paris Cité University, Paris 75015, France.,Centre de Recherche Cardiovasculaire de Paris, INSERM U970, 20 rue Leblanc, Paris 75015, France
| | - Tom Wong
- Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, UK.,National Heart and Lung Institute, Imperial College School of Medicine, London, UK
| | - Michael A Gatzoulis
- Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, UK.,National Heart and Lung Institute, Imperial College School of Medicine, London, UK
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Rodrigues C, Silva M, Cerejo R, Rodrigues R, Sousa L, Trigo C, Branco L, Agapito A, Fragata J. Quality of life among adults with repaired tetralogy of fallot: A literature review. Rev Port Cardiol 2021; 40:969-974. [PMID: 34922706 DOI: 10.1016/j.repce.2021.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 02/03/2021] [Indexed: 11/19/2022] Open
Abstract
Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect. Survival into adulthood is currently expected following surgical repair, leading to a growing population of adults with repaired TOF. In this literature review, we aim to summarize the current state of knowledge on the quality of life of adults with repaired TOF. A search was conducted on PubMed and results were reviewed for articles published between January of 2010 and June of 2020. Search terms included "Tetralogy of Fallot", "repaired", "adults" and "quality of life". For the subjective health status evaluation, most published studies used Short-Form-36. Most studies agree that physical complex status is poorer for adult patients with repaired TOF than for controls. Mental complex status was also lower. Patients reported similar satisfaction with their lives and levels of social participation. Most patients had a college or university degree. Higher education, male gender and having a partner were positively associated with being employed. Studies found no difference in the proportion of patients that are married or living with a partner, compared to control groups. Patients operated for TOF have a lower reproduction rate compared with the background population. A consistent finding of these studies is abnormal physical parameters compared to psychosocial issues. The diverse needs of adults with repaired TOF require a multidisciplinary care, that takes into consideration all aspects that affect their quality of life. Despite abnormal physical functional status, it is reassuring that most adult patients with TOF lead independent and productive lives.
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Affiliation(s)
- Carolina Rodrigues
- Cardiothoracic Surgery Department, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central-EPE, Lisbon, Portugal; Biomedical Engineering Doctoral Program, Instituto Superior Técnico, Universidade de Lisboa, Portugal.
| | - Manuela Silva
- Cardiothoracic Surgery Department, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central-EPE, Lisbon, Portugal
| | - Rui Cerejo
- Cardiothoracic Surgery Department, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central-EPE, Lisbon, Portugal
| | - Rui Rodrigues
- Cardiothoracic Surgery Department, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central-EPE, Lisbon, Portugal
| | - Lídia Sousa
- Cardiology Department, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central-EPE, Lisbon, Portugal
| | - Conceição Trigo
- Pediatric Cardiology Department, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central-EPE, Lisbon, Portugal
| | - Luísa Branco
- Cardiology Department, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central-EPE, Lisbon, Portugal
| | - Ana Agapito
- Cardiology Department, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central-EPE, Lisbon, Portugal
| | - José Fragata
- Cardiothoracic Surgery Department, Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central-EPE, Lisbon, Portugal
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Huntgeburth M, Hohmann C, Ewert P, Freilinger S, Nagdyman N, Neidenbach R, Pieper L, Pieringer F, Lennerz C, Kaemmerer H, Kolb C. Implantable loop recorder for monitoring patients with congenital heart disease. Cardiovasc Diagn Ther 2021; 11:1334-1343. [PMID: 35070802 PMCID: PMC8748482 DOI: 10.21037/cdt-20-677] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/16/2020] [Indexed: 10/23/2023]
Abstract
BACKGROUND Patients with congenital heart defects (CHD) are prone to residua, sequels and complications from the underlying anomaly, where cardiac arrhythmias are one of the major causes for hospitalization, morbidity and mortality. The importance of the subcutaneous implantable loop recorder (ILR) for the detection and documentation of significant arrhythmias has increased over the last years. To date, however, there is little data on ILR use in the CHD population. METHODS In this single center, retrospective observational study, all CHD-patients with an ILR were identified who were under care of the German Heart Center Munich between February 2015 and January 2019. The primary endpoint of the study was the detection or exclusion of significant arrhythmias during follow-up in CHD-patients who had received an ILR. The secondary endpoint was to determine whether ILR findings influenced patient management, defined as initiation or adjustment of medication, cardioversion, electrophysiologic study, catheter ablation, or implantation of cardiac implantable electronic devices (CIEDs) such as pacemakers (PM) or implantable cardioverter-defibrillators. RESULTS An ILR was implanted in 33 CHD-patients (mean age, 43±20 years; 42.4% female) with CHD. During a mean observation period of 697±433 days, clinically relevant arrhythmias, correlating with the patients' complaints and symptoms, were detected in 19 patients (59.4%), encompassing supraventricular tachycardia (n=10), supraventricular or ventricular ectopic beats (n=10), non-sustained ventricular tachycardia (n=2), ventricular tachycardia (n=2), and bradycardia (n=2). In 9 patients (28.1%) the detected arrhythmia was considered an event requiring treatment. Treatment modalities included catheter ablation (n=5), modification of antiarrhythmic drug regime (n=2), adaptation of anticoagulation therapy (n=2), or implantation of a subcutaneous ICD (n=1). Regarding the occurrence of cardiac arrhythmias or a related need for therapeutic intervention, no significant differences were identified with respect to WHO functional class, the presence of pulmonary arterial hypertension or reduced resting peripheral oxygen saturation. CONCLUSIONS In symptomatic CHD-patients at risk for life-threatening cardiac events, ILR has a considerable complementary diagnostic value for the detection and differentiation of benign and malignant arrhythmias. Considering the overall low risk of complications, ILR implantation should be considered in patients with CHD of any complexity who need medium or long-term arrhythmia monitoring, especially if short-term Holter monitoring cannot provide sufficient diagnostic certainty.
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Affiliation(s)
- Michael Huntgeburth
- Center for Adults with Congenital Heart Disease, Clinic III for Internal Medicine, Department of Cardiology, Heart Center, Medical Faculty, University Hospital of Cologne, Cologne, Germany
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Christopher Hohmann
- Center for Adults with Congenital Heart Disease, Clinic III for Internal Medicine, Department of Cardiology, Heart Center, Medical Faculty, University Hospital of Cologne, Cologne, Germany
| | - Peter Ewert
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Sebastian Freilinger
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Nicole Nagdyman
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Rhoia Neidenbach
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Lars Pieper
- Chair of Behavioural Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany
| | - Felix Pieringer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Carsten Lennerz
- Department of Electrophysiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Harald Kaemmerer
- Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
| | - Christof Kolb
- Department of Electrophysiology, German Heart Center Munich, Technical University of Munich, Munich, Germany
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Quality of life among adults with repaired tetralogy of fallot: A literature review. Rev Port Cardiol 2021. [DOI: 10.1016/j.repc.2021.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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7
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Health-related quality of life in adults with tetralogy of Fallot repair: a systematic review and meta-analysis. Qual Life Res 2021; 30:2715-2725. [PMID: 34021473 DOI: 10.1007/s11136-021-02875-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND With the advancement in diagnostics and clinical management, patients with Tetralogy of Fallot (ToF) are surviving till adulthood. Hence, assessing the impact of ToF repair on health-related quality of life (HRQOL) of these patients is becoming increasingly important. The objective of this paper is to conduct a systematic review and meta-analysis of the HRQOL in patients who have undergone ToF repair. METHODS A systematic search was conducted using PubMed, CINAHL, Medline and Web of Science databases. Studies that compared the HRQOL of adult patients (mean age ≥ 18 years) who had previously undergone ToF repair with healthy controls were included. Analysis was done via Revman V5.3 using a random effects model. RESULTS The 16 studies (15 using SF-36) included in the meta-analysis, comprised 1818 patients and 50,265 healthy controls. There was a higher proportion of males (59%). The mean ages at surgery and at HRQOL assessment were 5.37 years and 30.3 years, respectively. We found that repaired ToF patients had a statistically significantly lower score in the physical component summary (SMD = - 0.92 CI = - 1.54, - 0.30) and physical functioning (SMD = - 0.27 CI = - 0.50, - 0.03) compared to healthy controls. However, these patients had statistically significantly higher scores in the bodily pain domain (SMD = 0.35 CI = 0.12, 0.58) and social functioning (SMD = 0.23 CI = 0.01, 0.46), while there was no significant difference in other domains. CONCLUSION Overall, physical domain of HRQOL was statistically significantly lower in repaired ToF patients compared to healthy controls. However, repaired ToF patients scored significantly higher on bodily pain and Social Functioning. There was additionally no difference in the HRQOL between the two groups in other domains of HRQOL.
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Leusveld EM, Kauling RM, Geenen LW, Roos-Hesselink JW. Heart failure in congenital heart disease: management options and clinical challenges. Expert Rev Cardiovasc Ther 2020; 18:503-516. [DOI: 10.1080/14779072.2020.1797488] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Elsbeth M. Leusveld
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Robert M. Kauling
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Laurie W. Geenen
- Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands
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Sakhi R, Kauling RM, Theuns DA, Szili-Torok T, Bhagwandien RE, van den Bosch AE, Cuypers JAAE, Roos-Hesselink JW, Yap SC. Early detection of ventricular arrhythmias in adults with congenital heart disease using an insertable cardiac monitor (EDVA-CHD study). Int J Cardiol 2020; 305:63-69. [PMID: 32057477 DOI: 10.1016/j.ijcard.2020.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/27/2019] [Accepted: 02/03/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Sudden cardiac death (SCD) due to ventricular arrhythmias (VA) is an important mode of death in adults with congenital heart disease (CHD). Risk stratification is difficult in this heterogeneous population. Insertable cardiac monitors (ICM) may be useful for risk stratification. The purpose of the present study was to evaluate the use of ICM for the detection of VA in adults with CHD. METHODS In this prospective single-center observational study we included consecutive adults with CHD deemed at risk of VA who received an ICM between March 2013 and February 2019. The decision to implant an ICM was made in a Heart Team consisting of a cardiac electrophysiologist and a cardiologist specialized in CHD. RESULTS A total of 30 patients (mean age, 38 ± 15 years; 50% male) received an ICM. During a median follow-up of 16 months, 8 patients (27%) had documented nonsustained VA. Of these 8 patients, 3 (10%) received a prophylactic ICD. Furthermore, ICM-detected arrhythmias were present in 22 patients (73%) leading to a change in clinical management in 16 patients (53%). Besides the patients receiving an ICD, 10 patients (33%) had a change in their antiarrhythmic drugs, 6 patients (20%) underwent an electrophysiology study, and 1 patient (3%) received a pacemaker. CONCLUSIONS The detection of VA by the ICM contributed to the clinical decision to implant a prophylactic ICD. Furthermore, ICM-detected arrhythmias led to important changes in the clinical management. Therefore, long-term arrhythmia monitoring by an ICM seems valuable for risk stratification in adults with CHD.
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Affiliation(s)
- Rafi Sakhi
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Robert M Kauling
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Dominic A Theuns
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Tamas Szili-Torok
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Rohit E Bhagwandien
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Annemien E van den Bosch
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Judith A A E Cuypers
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jolien W Roos-Hesselink
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sing-Chien Yap
- Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
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Moons P, Luyckx K. Quality-of-life research in adult patients with congenital heart disease: current status and the way forward. Acta Paediatr 2019; 108:1765-1772. [PMID: 31136004 DOI: 10.1111/apa.14876] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/11/2019] [Accepted: 05/23/2019] [Indexed: 12/18/2022]
Abstract
Over the past four decades, the number of papers on quality of life (QoL) in congenital heart disease (CHD) has grown exponentially. However, firm conclusions have been hard to draw, because conceptual issues occurred and methodological differences prevented direct comparisons of studies. In general, QoL in CHD patients is good and it can be even better than in healthy peers when measured as life satisfaction. When QoL is measured as physical functioning, patients with complex CHD do worse than patients with moderate or mild defects or healthy individuals. APPROACH-IS was a large-scale international project that confirmed international variations in QoL, with Australian patients reporting the best QoL. Poor QoL was predicted by older age, being a job seeker, unemployed or disabled, never having married and those with worse functional status. Perceived illness and religion and spirituality were also significant predictors for QoL. On the other hand, country-specific characteristics and healthcare system factors did not play a significant role in explaining variances in QoL of patients with CHD around the globe. Future studies should rely on a sound conceptual basis, use longitudinal research designs, be conducted in international, multi-centre settings and evaluate interventions that promote patients' QoL.
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Affiliation(s)
- Philip Moons
- Department of Public Health and Primary Care KU Leuven Leuven Belgium
- Institute of Health and Care Sciences Gothenburg University Gothenburg Sweden
- Department of Paediatrics and Child Health University of Cape Town Cape Town South Africa
| | - Koen Luyckx
- School Psychology and Development in Context KU Leuven ‐ University of Leuven Leuven Belgium
- UNIBS, University of the Free State Bloemfontein South Africa
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Decreased Quality of Life Due to Driving Restrictions After Cardioverter Defibrillator Implantation. J Cardiovasc Nurs 2018; 33:474-480. [DOI: 10.1097/jcn.0000000000000474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Haddow G, Harmon SHE, Gilman L. Implantable Smart Technologies (IST): Defining the 'Sting' in Data and Device. HEALTH CARE ANALYSIS 2017; 24:210-27. [PMID: 26646672 PMCID: PMC4987398 DOI: 10.1007/s10728-015-0309-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In a world surrounded by smart objects from sensors to automated medical devices, the ubiquity of ‘smart’ seems matched only by its lack of clarity. In this article, we use our discussions with expert stakeholders working in areas of implantable medical devices such as cochlear implants, implantable cardiac defibrillators, deep brain stimulators and in vivo biosensors to interrogate the difference facets of smart in ‘implantable smart technologies’, considering also whether regulation needs to respond to the autonomy that such artefacts carry within them. We discover that when smart technology is deconstructed it is a slippery and multi-layered concept. A device’s ability to sense and transmit data and automate medicine can be associated with the ‘sting’ of autonomy being disassociated from human control as well as affecting individual, group, and social environments.
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Affiliation(s)
- Gill Haddow
- Science, Technology and Innovation Studies, The University of Edinburgh, Edinburgh, UK.
| | - Shawn H E Harmon
- Edinburgh Law School, The University of Edinburgh, Edinburgh, UK
| | - Leah Gilman
- Science, Technology and Innovation Studies, The University of Edinburgh, Edinburgh, UK
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13
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Steele MM, Zahr RA, Kirshbom PM, Kopf GS, Karimi M. Quality of Life for Historic Cavopulmonary Shunt Survivors. World J Pediatr Congenit Heart Surg 2017; 7:630-4. [PMID: 27587501 DOI: 10.1177/2150135116658009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/31/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Beginning with Dr William Glenn in 1958, 90 patients with congenital heart lesions underwent cavopulmonary (Glenn) shunts over a 30-year period. In 2015, the follow-up data on this original cohort were reported. The study focuses on the current quality of life of this cohort. METHODS Of the original 91 cavopulmonary shunt survivors, 14 (ages: 26-59; average length of postsurgical follow-up: 38.4 years) completed the Rand 36-Item Short-Form Health Survey, volume 2 (SF-36v2) quality-of-life survey at clinical office visits, over the phone or via regular mail. Diagnoses included tricuspid atresia (n = 9), double inlet left ventricle (n = 1), d-transposition of great arteries (n = 1), Ebstein's anomaly (n = 1), tetralogy of Fallot (n = 1), and pulmonary atresia with hypoplastic right ventricle (n = 1). Norm-based comparison of cavopulmonary shunt survivors to the general population was performed using a one-sample t test. RESULTS The 36-question health survey, SF-36v2, provided physical and mental health summary measures standardized to achieve a mean of 50. The 14 survivors' physical composite score was 47.18 (standard deviation [SD]: 8.24; P = .22) and mental composite score was 52.71 (SD: 5.64; P = .095). CONCLUSION The cavopulmonary shunt is now a widely used surgical palliation for single-ventricle patients and can be associated with physical and mental health outcomes similar to the general US population. Cavopulmonary shunt survivors' SF-36v2 survey results do not demonstrate a statistically significant difference from the general US population in physical or mental health measures. The results of this study contribute to the discussion of quality of life for patients with congenital heart disease by following up with the oldest known survivors.
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Affiliation(s)
- Margaret M Steele
- Department of Surgery, Section of Cardiac Surgery, Pediatric Cardiothoracic Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Riad Abou Zahr
- Department of Pediatrics, Section of Pediatric Cardiology, Yale University School of Medicine, New Haven, CT, USA
| | - Paul M Kirshbom
- Department of Surgery, Section of Cardiac Surgery, Pediatric Cardiothoracic Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Gary S Kopf
- Department of Surgery, Section of Cardiac Surgery, Pediatric Cardiothoracic Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Mohsen Karimi
- Department of Surgery, Section of Cardiac Surgery, Pediatric Cardiothoracic Surgery, Yale University School of Medicine, New Haven, CT, USA
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14
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Teuwen CP, Taverne YJHJ, Houck C, Götte M, Brundel BJJM, Evertz R, Witsenburg M, Roos-Hesselink JW, Bogers AJJC, de Groot NMS. Tachyarrhythmia in patients with congenital heart disease: inevitable destiny? Neth Heart J 2016; 24:161-70. [PMID: 26728051 PMCID: PMC4771626 DOI: 10.1007/s12471-015-0797-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The prevalence of patients with congenital heart disease (CHD) has increased over the last century. As a result, the number of CHD patients presenting with late, postoperative tachyarrhythmias has increased as well. The aim of this review is to discuss the present knowledge on the mechanisms underlying both atrial and ventricular tachyarrhythmia in patients with CHD and the advantages and disadvantages of the currently available invasive treatment modalities.
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Affiliation(s)
- C P Teuwen
- Department of Cardiology, Erasmus University Medical Center, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - Y J H J Taverne
- Department of Cardio-Thoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - C Houck
- Department of Cardiology, Erasmus University Medical Center, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - M Götte
- Department of Cardiology, Haga Hospital, The Hague, The Netherlands
| | - B J J M Brundel
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands
- Department of Physiology, Institute of Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands
| | - R Evertz
- Department of Cardiology, University Medical Center St. Radboud, Nijmegen, The Netherlands
| | - M Witsenburg
- Department of Cardiology, Erasmus University Medical Center, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - J W Roos-Hesselink
- Department of Cardiology, Erasmus University Medical Center, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands
| | - A J J C Bogers
- Department of Cardio-Thoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - N M S de Groot
- Department of Cardiology, Erasmus University Medical Center, 's Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands.
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Budts W, Roos-Hesselink J, Rädle-Hurst T, Eicken A, McDonagh TA, Lambrinou E, Crespo-Leiro MG, Walker F, Frogoudaki AA. Treatment of heart failure in adult congenital heart disease: a position paper of the Working Group of Grown-Up Congenital Heart Disease and the Heart Failure Association of the European Society of Cardiology. Eur Heart J 2016; 37:1419-27. [PMID: 26787434 DOI: 10.1093/eurheartj/ehv741] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 12/14/2015] [Indexed: 12/11/2022] Open
Affiliation(s)
- Werner Budts
- Congenital and Structural Cardiology, University Hospitals Leuven, Herestraat 49, B-3000 Leuven, Belgium
| | - Jolien Roos-Hesselink
- Department of Cardiology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Tanja Rädle-Hurst
- Department of Pediatric Cardiology, Saarland University Medical Center, Homburg, Germany
| | | | | | - Ekaterini Lambrinou
- Department of Nursing, School of Health Sciences Cyprus University of Technology, Limassol, Cyprus
| | - Maria G Crespo-Leiro
- Advanced Heart Failure and Heart Transplantation Unit, Cardiology Service, Hospital Universitario A Coruña, La Coruña, Spain
| | - Fiona Walker
- Centre for Grown-Up Congenital Heart Disease, St Bartholomews Hospital, London, UK
| | - Alexandra A Frogoudaki
- Adult Congenital Heart Clinic, Second Cardiology Department, ATTIKON University Hospital and Athens University, Athens, Greece
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Tomzik J, Koltermann KC, Zabel M, Willich SN, Reinhold T. Quality of Life in Patients with an Implantable Cardioverter Defibrillator: A Systematic Review. Front Cardiovasc Med 2015; 2:34. [PMID: 26664905 PMCID: PMC4671346 DOI: 10.3389/fcvm.2015.00034] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 10/20/2015] [Indexed: 12/02/2022] Open
Abstract
Despite the indisputable mortality advantages of implantable cardioverter defibrillators (ICDs), no consensus exists regarding their impact on quality of life (QoL). This systematic review investigates differences in QoL between patients with ICDs and controls. We systematically searched the MEDLINE, EMBASE, Cochrane, Web of Science, and PsychINFO databases. Articles were included if they were published after the year 2000 and reported on original studies with a control group. Five randomized controlled trials with a total of 5,138 patients and 10 observational studies with a total of 1,513 patients met the inclusion criteria. Nine studies found comparable QoL for ICD recipients and patients in the control groups, three studies found an increased QoL for ICD patients, and three studies found a decreased QoL for ICD patients. The question of whether QoL relates to ICD therapy cannot be answered conclusively due to the heterogeneity of the existing studies. Lower QoL was apparent among patients with an ICD who experienced several device discharges. Medical staff should be particularly aware of the signs of both psychological and physical disorders in these patients. Further investigations on QoL in ICD patients are desirable, but ethical reasons restrict the conduct of randomized trials.
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Affiliation(s)
- Juliane Tomzik
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin , Berlin , Germany
| | - Katharina C Koltermann
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin , Berlin , Germany
| | - Markus Zabel
- Department of Cardiology and Pneumology, University of Göttingen , Göttingen , Germany
| | - Stefan N Willich
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin , Berlin , Germany
| | - Thomas Reinhold
- Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin , Berlin , Germany
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19
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Analysis of associations between congenital heart defect complexity and health-related quality of life using a meta-analytic strategy. Int J Cardiol 2015. [PMID: 26204568 DOI: 10.1016/j.ijcard.2015.07.045] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND As a consequence of heterogeneous results of relatively small individual trials, the impact of congenital heart defects (CHD) and the effect of disease severity on patient reported outcome measures (PROs) of quality of life (QoL) remains uncertain. We aimed to systematically summarize QoL data in CHD patients using meta-analytic methods. METHODS AND RESULTS We performed a systematic review of the literature focusing on QoL in CHD. The search yielded 234 publications meeting the inclusion criteria, with a median of 88 patients per study (46% females, average age 24years). In total, QoL was reported using PROs in 47,471 CHD-patients. More than 95 different PROs were used to evaluate QoL. The most commonly used tool was the SF36 form (69 publications). Analysis of available quantitative QoL data from SF36 publications (n=4217 CHD patients) showed that QoL was reduced in patients with moderate or complex cardiac disease (e.g. relative physical functioning scores 0.96 [0.93-0.99] and 0.91 [0.88-0.95] compared with controls), while no such effect was evident in those patients with simple cardiac lesions. Similar results were found for the general health domain of the SF36 domain. CONCLUSIONS Despite the proliferation of QoL-studies in CHD no standardized approach for measuring and reporting QoL has emerged and the published results are heterogeneous. In aggregation, however, the results of this study suggest that QoL is impaired in moderate or complex CHD, while no such impact of CHD on QoL could be established--on average--in patients with simple defects.
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Bedair R, Babu-Narayan SV, Dimopoulos K, Quyam S, Doyle AM, Swan L, Gatzoulis MA, Wong T. Acceptance and psychological impact of implantable defibrillators amongst adults with congenital heart disease. Int J Cardiol 2015; 181:218-24. [DOI: 10.1016/j.ijcard.2014.12.028] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Revised: 11/14/2014] [Accepted: 12/01/2014] [Indexed: 12/01/2022]
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Abstract
Despite the clinical benefit of implantable cardioverter defibrillator (ICD), there is a high frequency of inappropriate ICD therapy associated with impaired quality of life, unwanted health care resource utilization, and adverse clinical outcome. Alternative strategies of ICD programming are needed to reduce the risk of inappropriate and "unnecessary" ICD therapies and to improve patient outcome. In this review, we provide an overview of the rate of inappropriate and appropriate ICD therapies in clinical trials and large registries as well as a review of current trials evaluating novel ICD programming to reduce inappropriate ICD therapy to avoid unnecessary ICD therapy. Based on recent studies including a large randomized trial, we recommend a simple programming approach involving high-rate device therapy beginning at 200 bpm with a 2.5 sec delay for it reduces inappropriate therapy, unnecessary therapy, and all-cause mortality in patients receiving ICD or CRT-D devices for primary prevention indications.
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Affiliation(s)
- Valentina Kutyifa
- Heart Research Follow-Up Program, University of Rochester Medical Center, Rochester, NY, USA,
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22
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ICD therapy for primary prevention of sudden cardiac death after Mustard repair for d-transposition of the great arteries. Clin Res Cardiol 2014; 103:894-901. [DOI: 10.1007/s00392-014-0727-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 05/08/2014] [Indexed: 01/24/2023]
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Apers S, Luyckx K, Moons P. Quality of life in adult congenital heart disease: what do we already know and what do we still need to know? Curr Cardiol Rep 2014; 15:407. [PMID: 23955787 DOI: 10.1007/s11886-013-0407-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Quality of life (QOL) is a key outcome in patients with congenital heart disease (CHD) because CHD has become a chronic condition accompanied by lifelong impairments. Recently, published studies on QOL in adults with CHD have reported inconsistent findings. Patients' QOL seems to depend on multiple factors and is not solely determined by their heart defect and various medical or demographic characteristics. For instance, evidence suggests that a strong sense of coherence might be an important pathway to improve QOL. However, studies on QOL and its determinants are characterized by important methodological differences and limitations, making it impossible to draw firm conclusions. To fill the gaps in the current evidence base, longitudinal and international research is needed. Furthermore, the research field on QOL in CHD should move on from observational studies to interventional research to guide health professionals in improving QOL.
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Affiliation(s)
- Silke Apers
- Centre for Health Services and Nursing Research, KU Leuven Department of Public Health and Primary Care, Kapucijnenvoer 35, Box 7001, 3000, Leuven, Belgium.
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Cuypers JAAE, Eindhoven JA, Slager MA, Opi P, Utens EMWJ, Helbing WA, Witsenburg M, van den Bosch AE, Ouhlous M, van Domburg RT, Rizopoulos D, Meijboom FJ, Bogers AJJC, Roos-Hesselink JW. The natural and unnatural history of the Mustard procedure: long-term outcome up to 40 years. Eur Heart J 2014; 35:1666-74. [DOI: 10.1093/eurheartj/ehu102] [Citation(s) in RCA: 123] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Psychosocial Functioning and Quality of Life in Adults with Congenital Heart Disease and Heart Failure. Heart Fail Clin 2014; 10:35-42. [DOI: 10.1016/j.hfc.2013.09.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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26
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Jaarsma T, Deaton C, Fitzsimmons D, Fridlund B, Hardig BM, Mahrer-Imhof R, Moons P, Noureddine S, O’Donnell S, Pedersen SS, Stewart S, Strömberg A, Thompson DR, Tokem Y, Kjellström B. Research in cardiovascular care: A position statement of the Council on Cardiovascular Nursing and Allied Professionals of the European Society of Cardiology. Eur J Cardiovasc Nurs 2013; 13:9-21. [DOI: 10.1177/1474515113509761] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Tiny Jaarsma
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Linköping, Sweden
| | - Christi Deaton
- School of Nursing, Midwifery & Social Work, Central Manchester University Hospitals NHS Foundation Trust, UK
| | | | - Bengt Fridlund
- School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Bjarne M Hardig
- Physio-Control Sweden/Jolife AB, Sweden; Department of Cardiology, Lund University, Sweden
| | - Romy Mahrer-Imhof
- Institute of Nursing, Zurich University of Applied Sciences, Switzerland
| | - Philip Moons
- Department of Public Health and Primary Care, University of Leuven, Belgium; The Heart Centre, Copenhagen University Hospital, Denmark
| | - Samar Noureddine
- Hariri School of Nursing, American University of Beirut, Lebanon
| | | | - Susanne S Pedersen
- Department of Medical and Clinical Psychology, Tilburg University, The Netherlands; Thorax Center, Erasmus Medical Center, The Netherlands; Institute of Psychology, University of Southern Denmark, Denmark; Department of Cardiology, Odense University Hospital, Denmark
| | - Simon Stewart
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence to Reduce Inequality in Heart Disease & Preventative Health, Baker IDI Heart and Diabetes Institute, Australia
| | - Anna Strömberg
- Department of Medicine and Health Sciences, Linköping University, Sweden; Department of Cardiology, County Council of Östergötland, Sweden
| | - David R Thompson
- Cardiovascular Research Centre, Australian Catholic University, Australia
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Mizuno A, Niwa K, Matsuo K, Kawada M, Miyazaki A, Mori Y, Nakanishi N, Ohuchi H, Watanabe M, Yao A, Inai K. Survey of reoperation indications in tetralogy of fallot in Japan. Circ J 2013; 77:2942-7. [PMID: 24042321 DOI: 10.1253/circj.cj-13-0673] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although the survival rate for repaired Tetralogy of Fallot (TOF) is dramatically improving, anatomical and functional residua and sequelae followed by arrhythmias and sudden death are still challenging issues to be resolved. Reoperation can reduce the incidence of arrhythmias and sudden death, but there is no consensus on the indications of reoperation for patients with TOF, especially in Japan. METHODS AND RESULTS A cross-sectional questionnaire survey of reoperation indications in patients with TOF was performed through a Japanese multicenter study. The questionnaire, which focused on the number of repaired TOF patients aged >15 years old, reoperation indications and management, was sent to the institutions belonging to Japanese Society for Adult Congenital Heart Disease. In total, 41.5% (78/188) of the institutions replied. The total number of repaired TOF patients was 4,010, and sudden cardiac death was observed in 45.236/4,010 (5.9%) experienced reoperation. Pulmonary stenosis (32%) and pulmonary regurgitation (29%) were the most common reasons for reoperation. There were only 2 implantable cardioverter defibrillator or resynchronization therapy defibrillator implantations. The physiological/anatomical indications of reoperation differed among the hospitals. CONCLUSIONS Approximately 1.1% of patients suffered sudden death and 6% of repaired TOF patients had reoperation. The indications of reoperation, however, varied among the institutions. Therefore, detailed information for each case of sudden death or reoperation should be collected and analyzed in order to establish guidelines for reoperation.
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Affiliation(s)
- Atsushi Mizuno
- Research Committee, Japanese Society for Adult Congenital Heart Disease, ST. Luke's International Hospital
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Pandya B, Quail MA, Cullen S. Clinical Issues and Outcomes in Adults Following Repair of Tetralogy of Fallot. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2013; 15:602-14. [DOI: 10.1007/s11936-013-0264-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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