Long-term incidence of atrial fibrillation and flutter after transcatheter atrial septal defect closure in adults

被引:43
作者
Giardini, Alessandro [1 ]
Donti, Andrea [1 ]
Sciarra, Francesca [1 ]
Bronzetti, Gabriele [1 ]
Mariucci, Elisabetta [1 ]
Picchio, Fernando M. [1 ]
机构
[1] Univ Bologna, Pediat Cardiol & Adult Congenital Unit, I-40138 Bologna, Italy
关键词
Atrial septal defect; Atrial fibrillation; Transcatheter closure; COMPLICATIONS;
D O I
10.1016/j.ijcard.2008.02.003
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The long-term risk of atrial fibrillation and flutter (AFF) after trascatheter atrial septal defects (ASD) closure in adults is unknown. Methods: We studied 134 patients who have undergone transcatheter ASD closure at our institution at an age of > 18 years (mean age 39 +/- 16 years); Patients were followed-up for 4.8 +/- 2.7 years (range 0.8-9.6 years). We assessed the presence of AFF both before and after ASD closure using standard 12 lead ECGs or 24h ambulatory Holter monitors. Results: 13 patients (10%) had documented AFF before the procedure (paroxysmal in 6, permanent in 7). Patients with AFF before the procedure were older (p < 0.0001), and had worse clinical condition (p = 0.0008). Patients without a history of AFF before the procedure and those who experienced paroxysmal AFF before the procedure had a very low annual risk (0%) of subsequent permanent AFF at long-term follow-up. Four patients with permanent AFF before the procedure (onset of < 12months) underwent electrical cardioversion immediately before ASD closure. Two of them (50%) are in sinus rhythm after 4.1 and 7.0 years, respectively. Conclusions: Transcatheter ASD closure performed in adults with no history of AFF or with a history of paroxysmal AFF before closure seems to protect from development of AFF in the long-term. In selected patients with permanent AFF at closure, device ASD closure together with arrhythmia cardioversion might be able to restore and maintain sinus rhythm in the long-term. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:47 / 51
页数:5
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