https://doi.org/10.4081/ecj.2025.13679
Palpitations in a Fontan patient: what now?
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Published: 7 March 2025
A 32-year-old male presented to our emergency department with palpitations. His blood pressure was 95/65 mmHg, heart rate 150 beats per minute, oxygen saturation 87% on room air, and body temperature 36°C. The electrocardiogram (EKG) showed paroxysmal supraventricular tachycardia (PSVT). He reported a history of heart surgery – Fontan procedure – during childhood for a complex congenital heart disease (CHD) characterized by a single atrium, a single ventricle, and a single atrioventricular valve. A focused cardiac ultrasound confirmed a single atrium, a single ventricle, no pericardial effusion, and an estimated ejection fraction of 50% (Videos 1 and 2). His current medication regimen included sotalol 80 mg, losartan 12.5 mg, dapagliflozin 10 mg, furosemide 25 mg, and warfarin.
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Fontan F, Baudet E. Surgical repair of tricuspid atresia. Thorax 197;26:240–8.
Laubham M, Blais B, Kamp AN. Atrial Arrhythmias in Adults with Fontan Palliation. Cardiol Ther 2023;12:473–87.
Dib N, Chaix MA, Samuel M, et al. Cardiovascular Outcomes in Fontan Patients With Right vs Left Univentricular Morphology: A Multicenter Study. JACC Adv 2024;3:100871.
Mariucci E, Bronzetti G, Donti A. Tachiaritmie nel paziente con cardiopatia congenita: diagnosi, presentazione clinica e trattamento. G Ital Cardiol 2023;24.
Hernández-Madrid A, Paul T, Abrams D, et al. ESC Scientific Document Group. Arrhythmias in congenital heart disease: a position paper of the European Heart Rhythm Association (EHRA), Association for European Paediatric and Congenital Cardiology (AEPC), and the European Society of Cardiology (ESC) Working Group on Grown-up Congenital heart disease, endorsed by HRS, PACES, APHRS, and SOLAECE. Europace 2018;20:1719-53.
Wasmer K, Eckardt L, Baumgartner H, Köbe J. Therapy of supraventricular and ventricular arrhythmias in adults with congenital heart disease—narrative review. Cardiovasc Diagn Ther 2021;11:550–62.
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