Pacemakers are associated with a higher risk of late death and transplantation in the Fontan population

Abstract

Background: The need for permanent pacing has been identified as a predictor of poor outcomes in the late survivors of Fontan surgery. However, it is not clear if the need for a pacemaker is a surrogate marker of a declining Fontan state, or if pacing is deleterious to the Fontan circulation. Objectives: We sought to compare the long-term outcomes of propensity-matched Fontan patients with and without a permanent pacemaker. Methods: Patients who have survived Fontan completion with a documented history of cardiac arrhythmia were identified from the Australia and New Zealand Fontan Registry. Pacemaker insertion details, cardiac function and electrophysiological data were obtained for the pati..