Background: Early and late arrhythmias are common following Fontan completion. The incidence of late arrhythmias has been shown to diminish with the use of an intracardiac lateral tunnel (ILT) compared to direct atriopulmonary connection. Little data are available for arrhythmia incidence following the use of an extracardiac conduit (ECC) for Fontan completion.
Patients and methods: The postoperative course of 51 consecutive survivors (surviving >6 months after Fontan completion) was analysed; 26 ILT Fontans (median age at Fontan completion 5.5 years; follow-up 58 to 120 months) versus 25 ECC Fontans (Fontan completion 3.4 years: follow-up 8 to 84 months).
Results: Early postoperative arrhythmias (<30 days)were observed in 14 patients (9 ILT - 3 sinus node disease, 2 complete AV block, 4 IART versus 5 ECC - 2 sinus node disease, 1 EAT, 1 AV block and 1 IART). Late arrhythmias (at >6 months post-Fontan) were seen in 15 patients (13 ILT - 5 late AV block and 2 sinus node disease (all requiring a permanent pacemaker), 5 IART (3 successfully ablated at catheterization) and 1 VT (requiring an ICD); versus 2 ECC (1 EAT (also observed in the early postoperative period) and 1 late AV block requiring pacing). There was 1 late death in the ILT subgroup, which was unrelated to arrhythmia.
Conclusions: The 2 groups differed substantially in age at Fontan completion and duration of follow-up. The preliminary data show that the incidence of early and late arrhythmia appears to be diminished following the routine practice of ECC Fontan completion.