Pacemaker-Related Factors and Outcomes of Fontan Patients　― Impact of Paced QRS Duration ―

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  • Shin Hyewon
    Division of Pediatric Cardiology, Department of Pediatrics, Asan Medical Center Children’s Hospital, Ulsan University College of Medicine
  • Baek Jae Suk
    Division of Pediatric Cardiology, Department of Pediatrics, Asan Medical Center Children’s Hospital, Ulsan University College of Medicine
  • Kim Mi Jin
    Division of Pediatric Cardiology, Department of Pediatrics, Asan Medical Center Children’s Hospital, Ulsan University College of Medicine
  • Cha Seulgi
    Division of Pediatric Cardiology, Department of Pediatrics, Asan Medical Center Children’s Hospital, Ulsan University College of Medicine
  • Yu Jeong Jin
    Division of Pediatric Cardiology, Department of Pediatrics, Asan Medical Center Children’s Hospital, Ulsan University College of Medicine

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<p>Background: Permanent pacemaker (PPM) implantation has been identified as a risk factor for morbidity and mortality after Fontan operation. This study investigated the factors associated with outcomes in patients with Fontan physiology who underwent PPM implantation.</p><p>Methods and Results: We retrospectively reviewed 508 patients who underwent Fontan surgery at Asan Medical Center between September 1992 and August 2022. Of these patients, 37 (7.3%) received PPM implantation. Five patients were excluded, leaving 32 patients, of whom 11 were categorized into the poor outcome group. Poor outcomes comprised death, heart transplantation, and “Fontan failure”. Clinical, Fontan procedure-related, and PPM-related factors were compared between the poor and good outcome groups. Ventricular morphology, Fontan procedure-associated factors, pacing mode, high ventricular pacing rate, and time from first arrhythmia to PPM implantation did not differ significantly between the 2 groups. However, the poor outcome group exhibited a significantly longer mean paced QRS duration (P=0.044). Receiver operating characteristic curve analysis revealed a paced QRS duration cut-off value of 153 ms with an area under the curve of 0.73 (P=0.035).</p><p>Conclusions: A longer paced QRS duration was associated with poor outcomes, indicating its potential to predict adverse outcomes among Fontan patients.</p>

収録刊行物

  • Circulation Journal

    Circulation Journal 88 (5), 642-648, 2024-04-25

    一般社団法人 日本循環器学会

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