OBJECTIVE: To determine whether transcatheter device closure of a secundum atrial septal defect (ASD) will reduce the risk of developing subsequent atrial arrhythmias. DESIGN: The incidence and predictors of symptomatic atrial tachyarrhythmias (AT) were examined in adults undergoing transcatheter closure of ASDs. SETTING: Toronto Congenital Cardiac Centre for Adults. PATIENTS: 132 consecutive patients, mean (SD) age 44 (16) years; 74% female. MAIN OUTCOME MEASURE: Sustained or symptomatic atrial arrhythmias at early follow up (six weeks; n = 115) and intermediate follow up (last clinic visit 17 (11) months post surgery; n = 121). RESULTS: 15% of the patients (20 of 132) had AT before the procedure (14 paroxysmal, six persistent). Patients without a history of arrhythmia had a low incidence of AT during early follow up (6%) and intermediate follow up (1%/year), while all patients with persistent AT before closure remained in atrial fibrillation or flutter. Of patients in sinus rhythm but with a previous history of AT, two thirds remained arrhythmia-free at follow up, with overall incidences of paroxysmal and persistent AT of 17%/year and 11%/year. A history of AT before closure (risk ratio (RR) 35.0, 95% confidence interval (CI) 7.2 to 169.0) and age > or = 55 years at the time of device insertion (RR 5.6, 95% CI 1.2 to 25.0) predicted AT after closure. CONCLUSIONS: Device closure of an ASD before the onset of atrial arrhythmias may protect against the subsequent development of arrhythmia, in particular in patients less than 55 years of age.
OBJECTIVE: To determine whether transcatheter device closure of a secundum atrial septal defect (ASD) will reduce the risk of developing subsequent atrial arrhythmias. DESIGN: The incidence and predictors of symptomatic atrial tachyarrhythmias (AT) were examined in adults undergoing transcatheter closure of ASDs. SETTING: Toronto Congenital Cardiac Centre for Adults. PATIENTS: 132 consecutive patients, mean (SD) age 44 (16) years; 74% female. MAIN OUTCOME MEASURE: Sustained or symptomatic atrial arrhythmias at early follow up (six weeks; n = 115) and intermediate follow up (last clinic visit 17 (11) months post surgery; n = 121). RESULTS: 15% of the patients (20 of 132) had AT before the procedure (14 paroxysmal, six persistent). Patients without a history of arrhythmia had a low incidence of AT during early follow up (6%) and intermediate follow up (1%/year), while all patients with persistent AT before closure remained in atrial fibrillation or flutter. Of patients in sinus rhythm but with a previous history of AT, two thirds remained arrhythmia-free at follow up, with overall incidences of paroxysmal and persistent AT of 17%/year and 11%/year. A history of AT before closure (risk ratio (RR) 35.0, 95% confidence interval (CI) 7.2 to 169.0) and age > or = 55 years at the time of device insertion (RR 5.6, 95% CI 1.2 to 25.0) predicted AT after closure. CONCLUSIONS: Device closure of an ASD before the onset of atrial arrhythmias may protect against the subsequent development of arrhythmia, in particular in patients less than 55 years of age.
Authors: C Pappone; G Oreto; S Rosanio; G Vicedomini; M Tocchi; F Gugliotta; A Salvati; C Dicandia; M P Calabrò; P Mazzone; E Ficarra; C Di Gioia; S Gulletta; S Nardi; V Santinelli; S Benussi; O Alfieri Journal: Circulation Date: 2001-11-20 Impact factor: 29.690
Authors: G R Veldtman; V Razack; S Siu; H El-Hajj; F Walker; G D Webb; L N Benson; P R McLaughlin Journal: J Am Coll Cardiol Date: 2001-06-15 Impact factor: 24.094
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Authors: S Konstantinides; A Geibel; M Olschewski; L Görnandt; H Roskamm; G Spillner; H Just; W Kasper Journal: N Engl J Med Date: 1995-08-24 Impact factor: 91.245
Authors: Michael Humenberger; Raphael Rosenhek; Harald Gabriel; Florian Rader; Maria Heger; Ursula Klaar; Thomas Binder; Peter Probst; Georg Heinze; Gerald Maurer; Helmut Baumgartner Journal: Eur Heart J Date: 2010-10-12 Impact factor: 29.983