Long-term Follow-up of Cardiac Rhythm in Repaired Total Anomalous Pulmonary Venous Drainage

Abstract

Seven consecutive patients with total anomalous pulmonary venous drainage were operated at the Medical College of Ohio at Toledo and long-term follow-up is reported on their rhythm status. The patients were generally under 3 months of age at operation. All patients are alive at the present time. The median length of follow-up is 4 years. Five of the 7 patients demonstrated ectopic pacemaker activity and 2 exhibited episodes of nodal rhythm as well. In general, these were not apparent on standard screening electrocardiography. There was no correlation between the presence or absence of this arrhythmia and the type of repair. It is concluded that arrhythmias may be present in these patients, but that they are unrelated to the type of surgery performed. The ectopic atrial focus may be of no clinical significance but there is more cause for concern in those patients with nodal rhythm.

Normal and abnormal development of pulmonary veins: State of the art and correlation with clinical entities

“…In general, in this patient group, arrhythmias are asymptomatic and not related to the type of surgery [118] (and Douglas et al unpublished results) Therefore, it is arguable whether the reported arrhythmias are related to the operation or to the pathological findings of TAPVC itself. Given the possible relation with sinus node dysfunction, for this patient category a careful follow-up including Holter registration is warranted.…”

Arrhythmic Burden of Adult Survivors With Repaired Total Anomalous Pulmonary Venous Connection

“…A strength of our study is the information on outcome in adult patients. Studies are extremely scares in this patient population due to the rarity of the defect and have almost exclusively been conducted in pediatric populations [26][27][28][29][30] . In 1991, Saxena et al described the presence of significant arrhythmias in 6 (37%) children out of 16, on 24h-ECG monitoring at a mean time of 8 years after isolated-TAPVC repair 28 .…”