Sudden cardiac death in adults with transposition of the gre
A retrospective cohort of 834 and 350 patients 16 years old with D-TGA and congenitally corrected TGA, respectively, was assembled from 11 expert centres.4 The primary outcome, ‘Major adverse ventricular Arrhythmias and Related Events (MAREs)’, occurred in 59 (5.0%) patients over a median follow-up of 9.4 years, corresponding to an incidence of 6.3 per 1000 patient-years. The most common MARE was sustained VT (49.2%), followed by SCD (20.3%), appropriate ICD therapy (18.6%), and resuscitated SCD (11.9%). Automated backward selection Cox regression yielded the following independent predictors: age at baseline, history of heart failure, syncope, QRS duration, severe systemic ventricular dysfunction, and left ventricular outflow tract obstruction >36 mmHg. Considering that the incidence of MAREs was significantly higher in congenitally corrected TGA (P=0.006), separate models were presented for each subgroup. The final model in D-TGA was similar to the combined results. Internal validation yielded a c-statistic of 0.85, suggesting strong model performance. In contrast, for congenitally corrected TGA, the only independent predictor of MAREs was history of heart failure. Presence of a pacemaker approached statistical significance (P=0.066).