Utility of Cardiac Magnetic Resonance Imaging in Predicting Atrial Arrhythmias in Repaired Tetralogy of Fallot
Section snippets
Methods
Patients ≥18 years of age with repaired TOF and no history of atrial arrhythmias who underwent cMRI performed between 2003 and 2020 were identified from a single tertiary US hospital (Duke University Medical Center, Durham, North Carolina) database. The first cMRI obtained at our center as an adult was generally considered the index cMRI, unless the images were inadequate for full analysis, in which case the first adequate scan was utilized.
Demographics (age at index cMRI, gender, race, and
Results
In total, 175 patients with repaired TOF who had undergone index cMRI at ≥18 years of age with no history of atrial arrhythmias were identified. Median age at time of initial surgical TOF repair was 3.1 years, and median age at the time of index cMRI was 33.7 years. Demographic, clinical, and surgical data of the study population are summarized in Table 1 and cMRI data in Table 2.
Over a median follow-up of 3.6 years, 29 patients (17%) developed atrial arrhythmias, including 15 with atrial
Discussion
This study identified age, RVEDVi, degree of TR, and diabetes mellitus as predictors of atrial arrhythmia development in repaired TOF. Among previous studies that have assessed cMRI metrics associated with atrial arrhythmias in this population, results are varied.1,8,12, 13, 14, 15 Studies with at least 20 outcomes that examined patients with no history of arrhythmias have either displayed no association between RV size and an isolated outcome of atrial arrhythmia development, or failed to
Disclosures
Dr. Spector received consulting fees from Janssen Research and Development. Dr. Campbell receives consulting fees from Longeveron Inc. Dr. Krasuski receives consulting fees from Actelion Pharmaceuticals and Gore Medical, and research funding from the Adult Congenital Heart Association, Actelion Pharmaceuticals, Corvia, CryoLife, Edwards Lifesciences, and Medtronic. The remaining authors have no conflicts of interest to declare.
Funding
None.
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