title: Predictors of sudden cardiac death after Mustard or Senning repair for transposition of the great arteries.
abstract: OBJECTIVE
  The goal of this research was to identify predictors for sudden death (SD) in patients with transposition of the great arteries (TGA) who have undergone atrial inflow repair.
  
  
  BACKGROUND
  Sudden death is the most common cause of late death after atrial inflow repair of TGA. Little is known about the predictors of SD.
  
  
  METHODS
  This was a retrospective, multicenter, case-controlled study. We identified 47 patients after Mustard's or Senning's operation who experienced an SD event (34 SD, 13 near-miss SD). Each patient was matched with two controls with the same operation, but without an SD event. Information on numerous variables before the event was obtained and compared with controls at the same time frame.
  
  
  RESULTS
  Presence of symptoms of arrhythmia or heart failure at most recent follow-up and history of documented arrhythmia (atrial flutter [AFL]/atrial fibrillation [AF]) were found to increase the risk of SD. Electrocardiogram (ECG), chest X-ray, and Holter ECG findings were not predictive of SD. Neither medication nor pacing was found to be protective. Most SD events (81%) occurred during exercise. Ventricular tachycardia/ventricular fibrillation were the recorded rhythm during SD in 21 of 47 patients.
  
  
  CONCLUSIONS
  Presence of symptoms and documented AFL/AF are the best predictors of SD in TGA patients. Patients with these findings should be further evaluated for risk of SD.
authors.affiliation: Department of Pediatric Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Janneke A E
authors.initials: JA
authors.lastname: Kammeraad
authors.forename: Carolien H M
authors.initials: CH
authors.lastname: van Deurzen
authors.forename: Narayanswami
authors.initials: N
authors.lastname: Sreeram
authors.forename: Margreet Th E
authors.initials: MT
authors.lastname: Bink-Boelkens
authors.forename: Jaap
authors.initials: J
authors.lastname: Ottenkamp
authors.forename: Willem A
authors.initials: WA
authors.lastname: Helbing
authors.forename: Jan
authors.initials: J
authors.lastname: Lam
authors.forename: Martha A
authors.initials: MA
authors.lastname: Sobotka-Plojhar
authors.forename: Otto
authors.initials: O
authors.lastname: Daniels
authors.forename: Seshadri
authors.initials: S
authors.lastname: Balaji
mesh_terms: D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000401:mortality; D002648:Child; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000517:prevention & control; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D014188:Transposition of Great Vessels / Q000401:mortality / Q000601:surgery*