Abstract
Background
In left atrial isomerism (LAI), both atria show left atrial morphology. Although bradyarrhythmias
are frequent and highly complex in LAI patients, previous studies have reported a
low incidence of supraventricular tachycardia (SVT).
Methods
To evaluate the incidence and characteristics of SVT in LAI, we retrospectively evaluated
the clinical characteristics of SVTs in 83 patients with LAI (age at last follow-up,
15.3±10.5 years).
Results
There were 27 SVTs in 19 patients (23%), including nine episodes of atrial fibrillation
(AF) and eight non-reentrant SVTs. Sixteen of the 19 patients with SVT had histories
of atriotomy, but the three patients with AF or non-reentrant tachycardia had no history
of atriotomy. The rates of freedom from SVT were 66% and 59% at ages of 20 and 30 years, respectively; the corresponding rates for freedom from AF were 89% and 74%.
In multivariate analysis, the predictors of SVT were age (OR, 1.14; 95% CI, 1.06–1.26;
p=0.003) and sinus node dysfunction (SND) (OR, 3.88; 95% CI, 1.57–13.34; p=0.01).
Conclusions
In patients with LAI, SVTs are common, and AF and non-reentrant SVTs are the major
type of SVTs. The incidence of AF was high in young patients with LAI. The lack of
anatomical barriers in the atria that allow the formation of macro-reentrant circuits
may account for the higher incidence of AF and non-reentrant SVT than macro-reentrant
tachycardia. Moreover, the increasing prevalence of SND with age should contribute
to a higher incidence of SVT.
Keywords
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Article info
Publication history
Published online: November 15, 2011
Accepted:
October 22,
2011
Received in revised form:
August 29,
2011
Received:
March 26,
2011
Footnotes
☆No grant support was received for this study.
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
