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[Permanent rhythm and conduction disorders in patients surgically treated for atrial septal defect]
A Medeiros1, P Iturralde, M Márquez
1Instituto Nacional de Cardiología Ignacio Chávez, INCICH, México, D.F.
Insights
Atrial septal defect (ASD) surgery can lead to arrhythmias. Risk factors include older age at repair, pulmonary hypertension, and pre-existing arrhythmias, impacting long-term cardiac health.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Cardiac Electrophysiology
Context:
- Atrial septal defect (ASD) is a congenital heart condition with generally good outcomes.
- However, atrial arrhythmias are known complications following surgical correction.
- Understanding these post-operative arrhythmias is crucial for patient management.
Purpose:
- To retrospectively assess the prevalence, types, and risk factors of arrhythmias in patients after surgical ASD correction.
- To identify specific patient characteristics and surgical factors associated with increased arrhythmia risk.
Summary:
- A retrospective study analyzed 460 patients undergoing surgical ASD repair, excluding complex cases.
- Pre-operative arrhythmias were present in 6.3% of patients.
- Six months post-surgery, 14.13% experienced arrhythmias, with atrial flutter being most common (44.6%).
- Key risk factors identified were older age at surgical repair, pulmonary hypertension, and pre-existing atrial arrhythmias.
Impact:
- Identifies significant risk factors for post-operative atrial arrhythmias in ASD patients.
- Provides valuable data for risk stratification and tailored patient follow-up strategies.
- Contributes to improving long-term cardiac outcomes for individuals with corrected ASD.
Abstract:
Atrial septal defect (ASD) represents a congenital heart disease with good prognosis, however, atrial arrhythmias are well-documented complications. A retrospective study was performed to assess the prevalence, types and risk factors of arrhythmias in patients with ASD after surgical correction. 920 patients were analyzed retrospectively; cases with complex congenital heart disease or another systemic alteration conditioning atrial rhythm disturbances were excluded. 460 patients with ASD corrected by surgery were followed at least for six months after the procedure. 29.3% of patients were male and 70.7% female. Direct closure was performed in 63%, pericardial patch was installed in 27%. 29 patients (6.3%) had conduction and rhythm disturbances before surgery, the most common arrhythmias were atrial flutter (34.5%), first degree A-V block (31%) and low right atrial rhythm (27.6%). Six months after atrial defect closure, 65 patients (14.13%) had arrhythmias, 44.6% atrial flutter, 20% ectopic atrial rhythm, 10.8% sick sinus syndrome. The risk of atrial arrhythmias was related to age at surgical repair, pulmonary hypertension and atrial arrhythmias before surgery.