Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-29T23:20:32.187Z Has data issue: false hasContentIssue false
  • English
  • Français

Arrhythmias in paediatric valvar disease*

Published online by Cambridge University Press:  29 December 2014

Jamie A. Decker
Jamie A. Decker*
Affiliation:
Division of Pediatric Cardiology, All Children’s Heart Institute, Saint Petersburg, Florida, United States of America
*
Correspondence to: J. A. Decker, MD, Division of Pediatric Cardiology, All Children’s Heart Institute, 601 5th Street South, Saint Petersburg, Florida 33701, United States of America. Tel: +727 767 3333; Fax: +727 767 8900; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Valvar heart disease can be complicated by hemodynamic derangements, depending on the degree of the abnormality. Stenosis causes pressure overload of the chamber draining through the valve and regurgitation results in volume overload. Many lesions have a component of both, resulting in both pressure and volume overload. Increased wall stress causes myocardial stretching and fibrosis, resulting in scarring; a nidus for arrhythmia development. Arrhythmias can complicate the clinical picture and increase the morbidity and mortality in patients with both congenital and acquired valvar disease. In adults with congenital heart disease, arrhythmias are the most common cause of sudden death, followed by heart failure. Valvar stenosis and insufficiency certainly contribute to this. This article highlights the need for arrhythmia surveillance for high-risk valvar lesions.

Keywords

Arrhythmiasvalvar heart diseasepediatrics
Type
Original Article
Information
Cardiology in the Young , Volume 24 , Issue 6: HeartWeek 2014 , December 2014 , pp. 1064 - 1070
Copyright
© Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Presented at All Children’s Hospital Johns Hopkins Medicine 14th International Symposium on Congenital Heart Disease, Saint Petersburg, Florida, 15–18 February 2014, Special Focus: Diseases of the Cardiac Valves from the Fetus to the Adult, Co-Sponsor: The American Association for Thoracic Surgery (AATS).

References

1.Lam, W, Friedman, RA. Electrophysiology issues in adult congenital heart disease. Methodist Debakey Cardiovasc J 2011; 7: 13–17.CrossRefGoogle ScholarPubMed
2.Koyak, Z, Harris, L, de Groot, JR, et al. Sudden cardiac death in adult congenital heart disease. Circulation 2012; 126: 1944–1954.Google Scholar
3.Silka, MJ, Bar-Cohen, Y. A contemporary assessment of the risk of sudden cardiac death in patients with congenital heart disease. Pediatr Cardiol 2012; 33: 452–460.Google Scholar
4.Hayek, E, Gring, CN, Griffin, BP. Mitral valve prolapse. Lancet 2005; 365: 507–518.Google Scholar
5.Toyono, M, Pettersson, GB, Matsumura, Y, et al. Preoperative and postoperative mitral valve prolapse and regurgitation in adult patients with secundum atrial septal defects. Echocardiography 2008; 25: 1086–1093.CrossRefGoogle ScholarPubMed
6.Nishimura, RA, McGoon, M, Shub, C, Miller, FA, Ilstrup, DM, Tajik, J. Echocardiographically documented mitral-valve prolapse. Longer-term follow-up of 237 patients. N Engl J Med 1985; 313: 1305–1309.CrossRefGoogle Scholar
7.Düren, DR, Becker, AE, Dunning, AJ. Long-term follow-up of idiopathic mitral valve prolapse in 300 patients; a prospective study. J Am Coll Cardiol 1988; 11: 42–47.Google Scholar
8.Kligfield, P, Levy, D, Devereux, RB, Savage, DD. Arrhythmias and sudden death in mitral valve prolapse. Am Heart J 1998; 113: 1298–1307.CrossRefGoogle Scholar
9.Anders, S, Said, S, Schulz, F, Puschel, K. Mitral valve prolapse syndrome as a cause of sudden death in young adults. Forensic Sci Int 2007; 171: 127–130.Google Scholar
10.Freed, LA, Benjamin, EJ, Levy, D, et al. Mitral valve prolapse in the general population: the benign nature of echocardiographic features in the Framingham Heart Study. J Am Coll Cardiol 2002; 40: 1298–1304.CrossRefGoogle ScholarPubMed
11.Corrado, D, Basso, C, Thiene, G. Sudden cardiac death in young people with apparently normal heart. Cardiovasc Res 2001; 50: 399–408.Google Scholar
12.Sriram, CS, Syed, FF, Ferguson, ME, et al. Malignant bileaflet mitral valve prolapse syndrome in patients with otherwise idiopathic out-of-hospital cardiac arrest. J Am Coll Cardio 2013; 62: 222–230.Google Scholar
13.Maron, BJ, Ackerman, MJ, Nishimura, RA, Pyeritz, RE, Towbin, JA, Udelson, JE. Task Force 4: HM and other cardiomyopathies, mitral valve prolapse, myocarditis, and Marfan syndrome. J Am Coll Cardiol 2005; 45: 1340–1345.Google Scholar
14.Delhaas, T, du Marchie Sarvaas, GJ, Rijlaarsdam, ME, et al. A multicenter, long-term study on arrhythmias in children with Ebstein’s anomaly. Pediatr Cardiol 2010; 31: 229–233.CrossRefGoogle Scholar
15.Attenhofer Jost, CH, Connolly, HM, Dearani, JA, Edwards, WD, Danielson, GK. Ebstein’s anomaly. Circulation 2007; 115: 277–285.Google Scholar
16.Roten, L, Lukac, P, de Groot, N, et al. Catheter ablation of arrhythmias in Ebstein’s anomaly: a multicenter study. J Cardiovasc Electrophysiol 2011; 22: 1391–1396.Google Scholar
17.Wolfe, RR, Driscoll, DJ, Gersony, WM, et al. Report from the second joint study on the natural history of congenital heart defects (NHS-2): arrhythmias in patients with valvar aortic stenosis, valvar pulmonary stenosis, and ventricular septal defect: results of 24-hour ECG monitoring. Circulation 1993; 87: 89–101.Google Scholar
18.Piorecka-Makula, A, Werner, B. Prolonged QT dispersion in children with congenital valvular aortic stenosis. Med Sci Monit 2009; 15: 534–538.Google Scholar
19.Nishimura, RA, Otto, CM, Bonow, RO, et al. AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg 2014; 148: e1–e132.Google Scholar
20.Greve, AM, Gerdts, E, Boman, K, et al. Impact of QRS duration and morphology on the risk of sudden cardiac death in asymptomatic patients with aortic stenosis: the SEAS study. J Am Coll Cardiol 2012; 59: 1142–1149.Google Scholar
21.Rafique, AM, Biner, S, Ray, I, Forrester, JS, Tolstrup, K, Siegel, RJ. Meta-analysis of prognostic value of stress testing in patients with asymptomatic severe aortic stenosis. Am J Cardiol 2009; 104: 972–977.Google Scholar
22.Decker, JA, Kim, JJ. Management of arrhythmias in patients with tetralogy of Fallot. Cardiol Young 2013; 23: 888–895.CrossRefGoogle ScholarPubMed
23.Czosek, RJ, Anderson, J, Khoury, PR, Knilans, TK, Spar, DS, Marino, BS. Utility of ambulatory monitoring in patients with congenital heart disease. Am J Cardiol 2013; 111: 720–730.CrossRefGoogle ScholarPubMed
24.Fish, FA, Gillette, PC, DW, Benson. Proarrhythmia cardiac arrest and death in young patients receiving encainide and flecainide. J Am Coll Cardiol 1991; 18: 356–365.Google Scholar
25.Perry, JC, Garson, A. Flecainide acetate for treatment of tachyarrhythmias in children: review of world literature on efficacy, safety, and dosing. Am Heart J 1992; 124: 1614–1621.Google Scholar
26.Echt, DS, Liebson, PR, Mitchell, LB, et al. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The cardiac arrhythmia suppression trial. N Engl J Med 1991; 324: 781–788.Google Scholar
27.Moffett, BS, Valdes, SO, Lupo, PJ, delaUz, C, Miyake, C, Krenek, M, Kim, JJ. Flecainide Use in Children with Cardiomyopathy or Structural Heart Disease. Pediatr Cardiol 2014 Aug 9. [Epub ahead of print]. PMID: 25107546.Google Scholar
28.Russo, AM, Stainback, RF, Bailey, SR, et al. ACCF/HRS/AHA/ASE/HFSA;SCAI/SCCT/SCMR 2013 appropriate use criteria for implantable cardioverter-defibrillators and cardiac resynchronization therapy: a report of the American College of Cardiology Foundation appropriate use criteria task force. Heart Rhythm 2013; 10: e11–e58.Google Scholar
29.Cannon, BC, Friedman, RA, Fenrich, AL, Fraser, CD, McKenzie, ED, Kertesz, NJ. Innovative techniques for placement of implantable cardioverter-defibrillator leads in patients with limited venous access to the heart. PACE 2006; 29: 181–187.CrossRefGoogle ScholarPubMed
30.Mondesert, B, Khairy, P. Implantable cardioverter-defibrillators in congenital heart disease. Curr Opin Cardiol 2014; 29: 45–52.Google Scholar