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

Lookup NU author(s): Dr Lee Ferguson, Dr Stephen Lord, Dr Ewen Shepherd, Dr John Bourke, Dr David Crossland, Dr John O'Sullivan


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© 2017 The Author. European Society of Cardiology. All rights reserved. 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.

Publication metadata

Author(s): Duong P, Ferguson LP, Lord S, Murray S, Shepherd E, Bourke JP, Crossland D, O'Sullivan J

Publication type: Article

Publication status: Published

Journal: EP Europace

Year: 2017

Volume: 19

Issue: 8

Pages: 1322-1326

Print publication date: 01/08/2017

Online publication date: 04/10/2016

Acceptance date: 29/05/2016

ISSN (print): 1099-5129

ISSN (electronic): 1532-2092

Publisher: Oxford University Press


DOI: 10.1093/europace/euw186


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