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. 2020 Jan;41(1):54-61.
doi: 10.1007/s00246-019-02221-0. Epub 2019 Oct 31.

Impact of Transcatheter Device Closure of Atrial Septal Defect on Atrial Arrhythmias Propensity in Young Adults

Michel Cabrera Ortega  1 , Dunia Bárbara Benítez Ramos  2 , Juan Carlos Ramiro Novoa  3 , Francisco Javier Ozores Suarez  3 , Francisco Díaz Ramírez  3 , Mabel Domínguez González  3
Affiliations

Impact of Transcatheter Device Closure of Atrial Septal Defect on Atrial Arrhythmias Propensity in Young Adults

Michel Cabrera Ortega et al. Pediatr Cardiol. 2020 Jan.

Abstract

Atrial septal defect (ASD) is a condition that requires early intervention because of the consequences over the right-side heart. Chronic atrial stretching promotes atrial conduction delay and the imbalance of the conduction homogeneity, which lead to the propensity to atrial arrhythmias (AA). We aim to evaluate the impact of transcatheter closure of ASD on atrial vulnerability markers leading to late AA in young adults. We conducted a prospective, longitudinal study in one hundred patients (mean age 25.2 ± 5.4 years) who underwent transcatheter closure of ASD at Cardiocentro Pediátrico William Soler. P-wave maximum (Pmax) and P-wave dispersion (Pd) were analyzed from 12-lead electrocardiogram. Left-side and right-side intraatrial and interatrial electromechanical delay (EMD) were measured with tissue Doppler imaging. Both electrocardiographic and echocardiographic analyses were performed during the study period. Compared to baseline, there was a significant reduction in P max (p ≤ 0.001) and Pd (p ≤ 0.001) after 3 months of procedure. All atrial electromechanical coupling parameters significantly reduced at 6 months of ASD closure and tend to remain at lower values till the last evaluation. Over 9.2 ± 1.6 years of follow-up, 15 subjects (15%) developed AA, of which intraatrial reentrant tachycardia (66.6%) became the main rhythm disturbance. Intra-right atrial EMD ≥ 16 ms (HR 4.08, 95% CI 1.15-14.56; p = 0.03) and Pd 45 ms (HR 1.66, 95% CI 1.06-2.59; p = 0.02) were identified as predictors of late AA. Transcatheter device closure of ASD in young adults promotes a significant reduction of electrocardiographic and echocardiographic markers of AA vulnerability, which persist during the long-term follow-up. Nevertheless, Pd and interatrial EMD were identified as independent risk factors of AA.

Keywords: Atrial arrhythmias; Atrial septal defect; Electrocardiographic markers; Electromechanic delay; Transcatheter closure.

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References

    1. Pediatr Cardiol. 2015 Jun;36(5):1050-6 - PubMed
    1. J Am Soc Echocardiogr. 2005 Sep;18(9):940-4 - PubMed
    1. G Ital Cardiol. 1999 Nov;29(11):1302-7 - PubMed
    1. Circulation. 2002 Jan 15;105(2):251-7 - PubMed
    1. Circulation. 2000 Jun 6;101(22):2631-8 - PubMed

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