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. 2025 Jul 28;16(4):373-379.
doi: 10.14740/cr2105. eCollection 2025 Aug.

Impact of Post-Procedural Atrial Arrhythmia on Long-Term Cardiac Function and Quality of Life Following Patent Foramen Ovale Closure

Zhao Xia Wang  1 , Xin Xin Fu  1 , Sai Hua Wang  1 , Jun Luo  1 , Ying Biao Wu  1 , Jia Hui Fang  1 , Ce Shi  1 , Zhong Ping Ning  1
Affiliations

Impact of Post-Procedural Atrial Arrhythmia on Long-Term Cardiac Function and Quality of Life Following Patent Foramen Ovale Closure

Zhao Xia Wang et al. Cardiol Res. .

Abstract

Background: Patent foramen ovale (PFO) is a common remnant of the embryonic development of the heart with an underestimated potential for morbidity and mortality. This study aimed to investigate the long-term impact of atrial arrhythmia (AA), a common complication after PFO closure, on cardiac function and quality of life (QoL) through a retrospective clinical analysis.

Methods: Patients who underwent percutaneous PFO closure between January 2022 and June 2024 were retrospectively identified. All patients underwent 24-h Holter electrocardiogram (ECG) monitoring prior to the procedure to screen for baseline atrial fibrillation (AF). Cardiac function and QoL were assessed after intervention and at long-term follow-up using echocardiographic parameters and questionnaires (SF-36), respectively.

Results: A total of 215 patients were included in this study. Sinus rhythm was present in all patients at baseline, and 26% developed AA during follow-up after PFO closure. The average follow-up period was 24 ± 7.8 months. Among the 56 patients with post-procedural AA, echocardiographic analysis showed that mitral E/A significantly increased at long-term follow-up compared to the immediate post-interventional period (1.20 ± 0.24 vs. 1.29 ± 0.18, P < 0.05). No statistically significant changes were observed in echocardiographic variables other than mitral E/A. In terms of QoL, only the score for social function improved significantly at long-term follow-up (65.21 ± 6.16 vs. 67.98 ± 7.59, P < 0.05), while no significant differences were found in the other subdomains.

Conclusions: AA, the common complication of PFO closure, has no impact on the long-term cardiac function and QoL of patients.

Keywords: Atrial arrhythmias; Cardiac function; Patent foramen ovale closure; Quality of life.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1
Figure 1
PFO closure procedure. Intraoperative image demonstrating transcatheter deployment of a double-disc occluder device across the atrial septum.
Figure 2
Figure 2
Comparison of SF-36 quality of life sub-domain scores between post-intervention and long-term follow-up periods in patients undergoing PFO closure. Radar chart displays eight sub-domains of the SF-36 questionnaire: overall health, physical health, physical function, emotional function, social function, physical pain, energy, and mental health. The purple line represents scores at long-term follow-up, while the navy line represents scores at the post-interventional period. Social function improved significantly at long-term follow-up (P < 0.05), highlighted by an asterisk. The inner and outer octagonal frames correspond to 60% and 90% of the maximum score range, respectively, providing a visual reference for relative domain performance. Source data are provided here (Supplementary Material 1, cr.elmerpub.com).
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