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Updated: Dec 7, 2025
Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
High-grade atrioventricular block occurring during percutaneous closure of patent foramen ovale: a case report
Marion Kibler1, Halim Marzak1, Laurence Jesel1,2
1Université de Strasbourg, Pôle d'Activité Médico-Chirurgicale Cardio-Vasculaire, Nouvel Hôpital Civil, Centre Hospitalier Universitaire, BP 426 - 67091 Strasbourg, France.
Insights
Percutaneous closure of patent foramen ovale (PFO) can cause temporary heart block. Using smaller PFO closure devices may prevent this complication during stroke treatment.
Area of Science:
- Cardiology
- Interventional Cardiology
- Electrophysiology
Background:
- Percutaneous closure of patent foramen ovale (PFO) is a recommended treatment for patients experiencing PFO-related stroke.
- Acute high-grade conduction disturbances during PFO closure have not been previously documented.
Observation:
- A case of reversible complete atrioventricular block during PFO closure is described.
- This conduction disturbance occurred during the deployment of a 35-mm PFO closure device.
Findings:
- The atrioventricular block was transient and resolved after the procedure.
- The likely cause was compression of the atrioventricular node by the device's right atrial disc.
Implications:
- Smaller PFO closure devices may reduce the risk of atrioventricular conduction disturbances.
- This finding suggests a need for careful device selection to prevent procedural complications.
Background:
Percutaneous closure of patent foramen ovale (PFO) is recommended for patients presenting with PFO-related stroke. Acute high-grade conduction disturbances occurring during PFO closure procedure have not been previously reported.
Case Summary:
We describe for the first time a case of reversible complete atrioventricular block which occurred during closure of a PFO.
Discussion:
We hypothesized that the block was the result of atrioventricular node compression-likely caused by the right-atrial disc of the 35-mm PFO closure device. We suggest implanting smaller devices in order to prevent atrioventricular conduction disturbances.
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