Volume 14, Issue 4 pp. 582-589

ORIGINAL ARTICLE

Pacemaker treatment after Fontan surgery—A Swedish national study

Jenny Alenius Dahlqvist MD,

Corresponding Author

Jenny Alenius Dahlqvist MD

[email protected]

orcid.org/0000-0001-8818-8762

Department of Clinical Sciences, Umeå University, Umeå, Sweden

Correspondence

Jenny Alenius Dahlqvist, Department of Clinical Sciences, Umeå University, 901 85 Umeå, Sweden.

Email: [email protected]

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Jan Sunnegårdh MD, PhD,

Jan Sunnegårdh MD, PhD

Department of Cardiology, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden

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Katarina Hanséus MD, PhD,

Katarina Hanséus MD, PhD

Department of Clinical Sciences Lund, Children’s Heart Center, Skåne University Hospital, Lund University, Lund, Sweden

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Eva Strömvall Larsson MD, PhD,

Eva Strömvall Larsson MD, PhD

Department of Cardiology, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden

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Anders Nygren MD, PhD,

Anders Nygren MD, PhD

orcid.org/0000-0003-0810-7016

Department of Cardiology, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden

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Magnus Dalén MD, PhD,

Magnus Dalén MD, PhD

Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

Department of Cardiac Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

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Håkan Berggren MD, PhD,

Håkan Berggren MD, PhD

Department of Pediatric Cardiac Surgery, Children’s Heart Center, The Queen Silvia Children’s Hospital, Gothenburg, Sweden

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Jens Johansson Ramgren MD,

Jens Johansson Ramgren MD

Department of Pediatric Cardiac Surgery, Children’s Heart Center, Skånes University Hospital, Lund, Sweden

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Urban Wiklund PhD,

Urban Wiklund PhD

orcid.org/0000-0002-1313-0934

Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden

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Annika Rydberg MD, PhD,

Annika Rydberg MD, PhD

Department of Clinical Sciences, Umeå University, Umeå, Sweden

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Jenny Alenius Dahlqvist MD,

Corresponding Author

Jenny Alenius Dahlqvist MD

[email protected]

orcid.org/0000-0001-8818-8762

Department of Clinical Sciences, Umeå University, Umeå, Sweden

Correspondence

Jenny Alenius Dahlqvist, Department of Clinical Sciences, Umeå University, 901 85 Umeå, Sweden.

Email: [email protected]

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Jan Sunnegårdh MD, PhD,

Jan Sunnegårdh MD, PhD

Department of Cardiology, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden

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Katarina Hanséus MD, PhD,

Katarina Hanséus MD, PhD

Department of Clinical Sciences Lund, Children’s Heart Center, Skåne University Hospital, Lund University, Lund, Sweden

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Eva Strömvall Larsson MD, PhD,

Eva Strömvall Larsson MD, PhD

Department of Cardiology, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden

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Anders Nygren MD, PhD,

Anders Nygren MD, PhD

orcid.org/0000-0003-0810-7016

Department of Cardiology, The Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Institute of Clinical Sciences, Gothenburg University, Gothenburg, Sweden

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Magnus Dalén MD, PhD,

Magnus Dalén MD, PhD

Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

Department of Cardiac Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

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Håkan Berggren MD, PhD,

Håkan Berggren MD, PhD

Department of Pediatric Cardiac Surgery, Children’s Heart Center, The Queen Silvia Children’s Hospital, Gothenburg, Sweden

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Jens Johansson Ramgren MD,

Jens Johansson Ramgren MD

Department of Pediatric Cardiac Surgery, Children’s Heart Center, Skånes University Hospital, Lund, Sweden

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Urban Wiklund PhD,

Urban Wiklund PhD

orcid.org/0000-0002-1313-0934

Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden

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Annika Rydberg MD, PhD,

Annika Rydberg MD, PhD

Department of Clinical Sciences, Umeå University, Umeå, Sweden

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First published: 18 March 2019

https://doi.org/10.1111/chd.12766

Citations: 13

Funding information

Hjärt-Lungfonden; Västerbotten Läns Landsting; Magnus Dalén was financially supported by the Senning Scholarship from the Swedish Association for Cardiothoracic Surgery

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Abstract

Objective

Fontan surgery is performed in children with univentricular heart defects. Previous data regarding permanent pacemaker implantation frequency and indications in Fontan patients are limited and conflicting. We examined the prevalence of and risk factors for pacemaker treatment in a consecutive national cohort of patients after Fontan surgery in Sweden.

Methods

We retrospectively reviewed all Swedish patients who underwent Fontan surgery from 1982 to 2017 (n = 599).

Results

After a mean follow-up of 12.2 years, 13% (78/599) of the patients with Fontan circulation had received pacemakers. Patients operated with the extracardiac conduit (EC) type of total cavopulmonary connection had a significantly lower prevalence of pacemaker implantation (6%) than patients with lateral tunnel (LT; 17%). Mortality did not differ between patients with (8%) and without pacemaker (5%). The most common pacemaker indication was sinus node dysfunction (SND) (64%). Pacemaker implantation due to SND was less common among patients with EC. Pacemaker implantation was significantly more common in patients with mitral atresia (MA; 44%), double outlet right ventricle (DORV; 24%) and double inlet left ventricle (DILV; 20%). In contrast, patients with pulmonary atresia with intact ventricular septum and hypoplastic left heart syndrome were significantly less likely to receive a pacemaker (3% and 6%, respectively).

Conclusions

Thirteen percent of Fontan patients received a permanent pacemaker, most frequently due to SND. EC was associated with a significantly lower prevalence of pacemaker than LT. Permanent pacemaker was more common in patients with MA, DORV, and DILV.

CONFLICT OF INTEREST

The authors declare that they have no conflicts of interest with the contents of this article.

REFERENCES

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Volume14, Issue4

July/August 2019

Pages 582-589

Pacemaker treatment after Fontan surgery—A Swedish national study

Abstract

Objective

Methods

Results

Conclusions

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

Information

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Pacemaker treatment after Fontan surgery—A Swedish national study

Abstract

Objective

Methods

Results

Conclusions

CONFLICT OF INTEREST

REFERENCES

Citing Literature

References

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