What happens when a Fontan fails?

Late Fontan failure may present insidiously over years. It is a failure of medical management to interpret the absence of overt symptoms or ascites as evidence of optimal haemodynamic status in the functionally univentricular circulation.

What are examples of arrhythmias?

The types of arrhythmias include:

• Premature atrial contractions.
• Premature ventricular contractions(PVCs).
• Atrial fibrillation.
• Atrial flutter.
• Paroxysmal supraventricular tachycardia (PSVT).
• Accessory pathway tachycardias.
• AV nodal reentrant tachycardia.
• Ventricular tachycardia (V-tach).

What is a Fontan patient?

The Fontan operation involves routing of systemic venous return directly into pulmonary circulation bypassing the subpulmonary ventricle. This is an effective palliation in patients with complex congenital heart disease involving single ventricle physiology.

How often do patients with Fontan circulation develop arrhythmia?

Up to 40% of patients with Fontan circulation will develop at least one arrhythmia in the 10 years after having Fontan surgery. Arrhythmias commonly occur because of dilation and scarring (from surgery) in the top chambers of the heart (the atria).

How long does it take for a Fontan heart to fail?

The development of significant arrhythmias in the atriopulmonary or atrioventricular Fontan modification, when coupled with signs of heart failure, is associated with a 3 year mortality rate of 25%. 6 Management of atrial arrhythmias in Fontan patients.

Why are Fontan palliation procedures so poorly tolerated?

About two-thirds of adult patients who undergo Fontan procedures have a history of atrial arrhythmias. Atrial arrhythmias are poorly tolerated in these patients because of reduced preload and a dependence on atrial systole to achieve adequate ventricular filling.

Is it common for Fontan patients to have atrial fibrillation?

Atrial fibrillation is becoming increasingly common in adult Fontan patients, and is present in almost half of patients referred for Fontan conversion.