Evidence map›Paper›PMID 33786365›Full record

ArticleInternational journal of cardiology. Heart & vasculature2021

Recurrent sustained atrial arrhythmias and thromboembolism in Fontan patients with total cavopulmonary connection.

Alexander C Egbe, William R Miranda, Janaki Devara, Likhita Shaik, Momina Iftikhar, Ahmed Goda Sakr, Anitha John, Ari Cedars, Fred Rodriguez, Jeremy P Moore and 6 more

Open access · goldAbstract read
In one paragraph

Article in International journal of cardiology. Heart & vasculature, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Changes in pharmacotherapy in adults with Fontan circulation and associations with outcomes.International journal of cardiology. Congenital heart disease · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 7 institutions in 1 country.

Alexander C EgbeDepartment of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States.
William R MirandaDepartment of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States.
Janaki DevaraDepartment of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States.
Likhita ShaikDepartment of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States.
Momina IftikharDepartment of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States.
Ahmed Goda SakrDepartment of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States.
Anitha JohnChildren's National Hospital, Washington DC, United States.
Ari CedarsUniversity of Texas, Southwestern Medical Center, United States.
Fred RodriguezEmory University Hospital and Children's Healthcare of Atlanta, GA, United States.
Jeremy P MooreAhmanson/UCLA Adult Congenital Heart Disease Center, UCLA Medical Center, Los Angeles, CA, United States.
Matthew RussellAhmanson/UCLA Adult Congenital Heart Disease Center, UCLA Medical Center, Los Angeles, CA, United States.
Jasmine GrewalUniversity of British Columbia, Vancouver, United States.
Salil GindeChildren's Hospital Wisconsin, United States.
Adam M LubertCincinnati Children's Hospital, OH, United States.
Heidi M ConnollyDepartment of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States.
Alliance for Adult Research in Congenital Cardiology (AARCC) investigators
Mayo Clinic in Arizona · USUCLA Medical Center · USChildren's Hospital of Wisconsin · USChildren's National · USCincinnati Children's Hospital Medical Center · USEmory University Hospital · USThe University of Texas Southwestern Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTotal cavopulmonary connection (TCPC) is associated with a lower risk of incident atrial arrhythmias as compared to atriopulmonary Fontan, but the risk of recurrent atrial arrhythmias is unknown in this population. The purpose of this study was to determine the incidence and risk factors for recurrent atrial arrhythmias and thromboembolic complications in patients with TCPC.

methodsThis is a retrospective multicenter study conducted by the Alliance for Adult Research in Congenital Cardiology (AARCC), 2000-2018. The inclusion criteria were TCPC patients (age > 15 years) with prior history of atrial arrhythmia.

resultsA total of 103 patients (age 26 ± 7 years; male 58 [56%]) met inclusion criteria. The mean age at initial arrhythmia diagnosis was 13 ± 5 years, and atrial arrhythmias were classified as atrial flutter/tachycardia in 85 (83%) and atrial fibrillation in 18 (17%). The median duration of follow-up from the first episode of atrial arrhythmia was 14.9 (12.1-17.3) years, and during this period 64 (62%) patients had recurrent atrial arrhythmias (atrial flutter/tachycardia 51 [80%] and atrial fibrillation 13 [20%]) with annual incidence of 4.4%. Older age was a risk factor for arrhythmia recurrence while the use of a class III anti-arrhythmic drug was associated with a lower risk of recurrent arrhythmias. The incidence of thromboembolic complication was 0.6% per year, and the cumulative incidence was 4% and 7% at 5 and 10 years respectively from the time of first atrial arrhythmia diagnosis. There were no identifiable risk factors for thromboembolic complications in this cohort.

conclusionsAlthough TCPC provides superior flow dynamics and lower risk of incident atrial arrhythmias, there is a significant risk of recurrent arrhythmias among TCPC patients with a prior history of atrial arrhythmias. These patients may require more intensive arrhythmia surveillance as compared to other TCPC patients.

Indexed as

AAD, anti-arrhythmic drug therapyAtrial arrhythmiaFontan operationTCPC, total cavopulmonary connectionThromboembolic complicationTotal cavopulmonary connection

Identifiers

PMID33786365
PMCPMC7988316
OpenAlexW3137008811

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.