Atrial arrhythmia after transcatheter closure of secundum atrial septal defects in patients ≥40 years of age

Duong, Phuoc, Ferguson, Lee P., Lord, Stephen, Murray, Stephen, Shepherd, Ewen, Bourke, John Pius, Crossland, David and O'Sullivan, John (2017) Atrial arrhythmia after transcatheter closure of secundum atrial septal defects in patients ≥40 years of age. Europace, 19 (8). pp. 1322-1326. ISSN 1532-2092

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Abstract

AIM:
Data on arrhythmia outcome following device closure of atrial septal defect (ASD) are lacking. This study provides medium-term follow-up data on atrial arrhythmias in patients who were ≥40 years of age at the time of transcatheter ASD closure.

METHODS AND RESULTS:
It is a retrospective review. Mean age of the 159 patients was 57 years. Median follow-up was 3.6 years (range 6 months - 10.9 years). Patients were classified, according to arrhythmia status prior to ASD closure, into Group I, no history of atrial arrhythmia (n = 119, mean age 55.5 years); Group II, paroxysmal atrial arrhythmia (n = 18, mean age 55.7 years); and Group III, persistent atrial fibrillation (n = 22, mean age 65.7 years). Group III patients were significantly older, had larger left atrial size, and had higher mean pulmonary arterial pressure than Group I and II patients (P < 0.001). Prior to closure, radiofrequency ablation was carried out in 12/18 (66%) of Group II and 3/22 (14%) of Group III. After device closure, 7 patients (6%) of Group I developed new atrial fibrillation. Fifty per cent (9/18) of Group II but only 9% (2/22) of Group III were in sinus rhythm on follow-up.

CONCLUSION:
Device closure alone in patients with persistent atrial arrhythmia is not likely to restore sinus rhythm in the medium term. New atrial arrhythmia occurred in 6% of patients who were in sinus rhythm prior to device closure. At least 50% of the patients with paroxysmal atrial arrhythmia continue to have significant atrial arrhythmia following device closure, and the role of ablation prior to closure in patients with a history of arrhythmia requires refinement.

Item Type:	Article
Uncontrolled Keywords:	Atrial septal defect, Device closure, Atrial arrhythmia, Radiofrequency ablation
Subjects:	A300 Clinical Medicine
Department:	Faculties > Health and Life Sciences > Nursing, Midwifery and Health
Depositing User:	Lee Ferguson
Date Deposited:	12 Dec 2016 11:21
Last Modified:	11 Oct 2019 20:51
URI:	http://nrl.northumbria.ac.uk/id/eprint/28866

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