Atrial arrhythmias and patient-reported outcomes in adults with congenital heart disease: An international study

Benjamin Casteigt, Michelle N. Samuel, Laurence Laplante, Azadeh Shohoudi, Silke Apers, Adrienne H. Kovacs, Koen Luyckx, Corina Thomet, Werner Budts, Junko Enomoto, Maayke A. Sluman, Chun-Wei Lu, Jamie L. Jackson, Stephen C. Cook, Shanthi Chidambarathanu, Luis Alday, Katrine Eriksen, Mikael Dellborg, Malin Berghammer, Bengt Erik JohanssonAndrew S. Mackie, Samuel A. Menahem, Maryanne Caruana, Gruschen Veldtman, Alexandra Soufi, Susan M. Fernandes, Kamila S. White, Edward Callus, Shelby Kutty, Judith Brouillette, Philip Moons, Paul Khairy

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Atrial arrhythmias  (ie, intra-atrial reentrant  tachycardia  and atrial fibrillation) are a leading cause of morbidity and hospitalization in adults with  congenital heart disease  (CHD). Little is known about their effect on quality of life and other patient-reported outcomes (PROs) in adults with CHD.
Objective
The purpose of this study was to assess the impact of atrial arrhythmias on PROs in adults with CHD and explore geographic variations.
Methods
Associations between atrial arrhythmias and PROs were assessed in a cross-sectional study of adults with CHD from 15 countries spanning 5 continents. A propensity-based matching weight analysis was performed to compare quality of life, perceived health status, psychological distress,  sense of coherence , and illness perception in patients with and those without atrial arrhythmias.
Results
A total of 4028 adults with CHD were enrolled, 707 (17.6%) of whom had atrial arrhythmias. After applying matching weights, patients with and those without atrial arrhythmias were comparable with regard to age (mean 40.1 vs 40.2 years), demographic variables (52.5% vs 52.2% women), and complexity of CHD (15.9% simple, 44.8% moderate, and 39.2% complex in both groups). Patients with atrial arrhythmias had significantly worse PRO scores with respect to quality of life, perceived health status, psychological distress (ie, depression), and illness perception. A summary score that combines all PRO measures was significantly lower in patients with atrial arrhythmias (–3.3%;  P  = .0006). Differences in PROs were consistent across geographic regions.
Conclusion
Atrial arrhythmias  in adults with CHD are associated with an adverse impact on a broad range of PROs consistently across various geographic regions.
Original languageAmerican English
JournalHeart Rhythm
Volume18
DOIs
StatePublished - May 2021

Disciplines

  • Psychology

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