Long term evaluation of electromechanical delay in patients with atrial septal defect after transcatheter closure

Area of Science:

• Cardiology
• Medical Devices
• Echocardiography

Background:

• Electromechanical delay (EMD) may increase atrial fibrillation risk and is prolonged in patients with various conditions, including secundum atrial septal defect (ASD).
• Previous studies have indicated prolonged EMD in ASD patients compared to healthy individuals.

Purpose of the Study:

• To prospectively evaluate the mid-term and long-term effects of transcatheter closure of secundum type ASD on atrial conduction and electromechanical delay.
• To assess changes in lateral atrial conduction time (PA), septal PA, tricuspid PA, left and right intra-atrial EMD (ILeft-EMD and IRight-EMD), and inter-atrial EMD (IA-EMD).

Main Methods:

• Prospective study of 45 secundum type ASD patients undergoing percutaneous transcatheter closure.
• Transthoracic echocardiography (TTE) performed before closure, and at 6 and 12 months post-closure.
• Measurement of various atrial conduction and EMD parameters using Doppler echocardiography.

Main Results:

• A statistically significant decrease in lateral PA, septal PA, tricuspid PA, ILeft-EMD, IRight-EMD, and IA-EMD was observed at 6 months post-closure compared to pre-closure values.
• Further statistically significant decreases in these parameters were noted at 12 months post-closure compared to 6-month values.
• Atrial EMD demonstrated improvement after device closure, with continued improvement observed up to 12 months.

Conclusions:

• Transcatheter closure of secundum type ASD leads to significant improvements in atrial electromechanical delay.
• The observed improvements in atrial conduction and EMD are sustained and continue to progress beyond 6 months post-closure.
• Device closure of ASD positively impacts atrial electrophysiological properties, suggesting potential benefits for atrial function and arrhythmia risk.