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Current Treatment Options of Fontan Arrhythmias: Management

  • Pediatric and Congenital Heart Disease (G Singh, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of the review

Arrhythmias are a common complication of patients with single ventricle anatomy who undergo the Fontan operation. This review will address current management strategies for acute and chronic arrhythmias.

Recent findings

Alterations to surgical techniques, newer antiarrhythmic medications, and improvements in catheter ablation procedures have improved the management of patients with arrhythmias following Fontan palliation.

Summary

Arrhythmias predict poor prognosis for Fontan patients. Early and aggressive management of arrhythmias improve patient outcomes. For bradyarrhythmias, management strategies strive to maximize atrial pacing and minimize ventricular pacing. For tachyarrhythmias, urgent evaluation and aggressive interventions strive to convert and maintain sinus rhythm. Strategies include antiarrhythmic medications, catheter ablation, and early referral for Fontan conversion and arrhythmia surgery for those who do not respond. There is much interest in prophylactic arrhythmia surgery at the time of initial Fontan operation; however, the future role remains to be elucidated.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Cardiology, Oregon Health & Science University, 707 SW Gaines Street, CDRC-P, Portland, OR, 97239, USA

    Mayme Marshall MD, Mohammad Alnoor MD & Seshadri Balaji MBBS, MRCP (UK), PhD

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  1. Mayme Marshall MD
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  2. Mohammad Alnoor MD
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  3. Seshadri Balaji MBBS, MRCP (UK), PhD
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Correspondence to Seshadri Balaji MBBS, MRCP (UK), PhD.

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Mayme Marshall declares that she has no conflict of interest. Mohammad Alnoor declares that he has no conflict of interest. Seshadri Balaji declares that he has no conflict of interest.

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Marshall, M., Alnoor, M. & Balaji, S. Current Treatment Options of Fontan Arrhythmias: Management. Curr Treat Options Cardio Med 22, 46 (2020). https://doi.org/10.1007/s11936-020-00848-4

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