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Updated: Jun 8, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
P-wave dispersion between transcatheter and surgical closure of secundum-type atrial septal defect in childhood
Osman Baspinar1, Murat Sucu, Senem Koruk
1Clinic of Pediatric Cardiology, Gaziantep University Medical Faculty, Gaziantep, Turkey. osmanbaspinar@hotmail.com
Insights
This study found no significant difference in P-wave dispersion between transcatheter and surgical closure for atrial septal defects in children. Both methods effectively manage P-wave dispersion, a predictor of atrial fibrillation.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Electrophysiology
Background:
- Atrial septal defect (ASD) increases the risk of atrial fibrillation.
- Increased P-wave dispersion is a known predictor for developing atrial fibrillation.
Purpose of the Study:
- To compare P-wave dispersion following transcatheter closure (Amplatzer septal occluder) versus surgical closure of secundum ASD in children.
- To evaluate the impact of closure method on atrial electrical activity and fibrillation risk.
Main Methods:
- Sixty-eight children with secundum ASDs were assessed.
- P-wave dispersion was measured using 12-lead surface electrocardiography before and after closure.
- Participants underwent either transcatheter closure (n=41) or surgical closure (n=27).
Main Results:
- P-wave dispersion, P maximum, and P minimum values were similar before and after both closure procedures.
- No statistically significant difference in P-wave dispersion was observed between the transcatheter and surgical groups.
- A significant decrease in P-wave dispersion was noted in the surgical group compared to baseline (p=0.03).
Conclusions:
- Transcatheter closure with the Amplatzer septal occluder and surgical closure are comparable in managing P-wave dispersion in pediatric ASD patients.
- Both methods appear effective in normalizing atrial electrical properties, potentially reducing future atrial fibrillation risk.
Abstract:
Patients with atrial septal defect have an increased risk for atrial fibrillation. Increased P-wave dispersion predicts the development of atrial fibrillation. The aim of this study was to determine difference in P dispersion between transcatheter closure with Amplatzer septal occluder and surgical closure in childhood. A total of 68 children (the mean age was 7.2 plus or minus 3.3 years; the mean secundum atrial septal defects diameter was 17.3 plus or minus 5.4 millimetres) were evaluated in this study. Transcatheter closure was attempted in 41 children with secundum atrial septal defects, and the defect in 27 patients was closed by surgical techniques. P maximum, P minimum and P dispersion were measured by the 12-lead surface electrocardiography. P maximum, P minimum and P dispersion were found to be similar in patients with pre- and post-procedure (98.0 plus or minus 19.3 versus 95.1 plus or minus 23.0 milliseconds; 68.0 plus or minus 20.8 versus 67.6 plus or minus 24.3 milliseconds, 29.9 plus or minus 11.0 versus 27.1 plus or minus 12.1 milliseconds, respectively). There was no statistical significance in the comparison of P dispersion between the two groups. But in the surgical group, P-wave dispersion was decreased more significantly compared with baseline values (p-value equal to 0.03). In conclusion, there is no P dispersion between transcatheter closure with Amplatzer septal occluder and surgical closure of secundum atrial septal defect.
