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Sympathovagal imbalance decades after atrial septal defect repair: a long-term follow-up study

Mathias Alstrup1,2, Zarmiga Karunanithi1,2, Marie Ø Maagaard1,2

  • 1Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|May 20, 2021
PubMed

Insights

Adults with corrected atrial septal defects (ASD) show impaired heart rate variability (HRV), indicating abnormal autonomic regulation. Surgical closure of ASDs resulted in more significant HRV reduction compared to percutaneous closure.

Area of Science:

  • Cardiology
  • Autonomic Nervous System Research
  • Medical Device Technology

Background:

  • Growing evidence links corrected atrial septal defects (ASD) to increased patient morbidity and mortality.
  • Autonomic dysregulation of cardiac function is a potential contributing factor.
  • Investigating heart rate variability (HRV) offers insights into autonomic control in these patients.

Purpose of the Study:

  • To assess autonomic cardiac regulation in adults with corrected ASDs using HRV analysis.
  • To compare HRV between surgically closed ASDs, percutaneously closed ASDs, and healthy controls.

Main Methods:

  • A 48-hour Holter monitor was utilized to record heart rate.
  • Heart rate variability (HRV) parameters were analyzed in adult patients with surgically or percutaneously closed ASDs.
  • A control group of healthy individuals was included for comparison.

Main Results:

  • Surgically closed ASD patients exhibited significantly reduced HRV across all six assessed parameters compared to controls.
  • Percutaneously closed ASD patients demonstrated decreased HRV in three out of six parameters when compared to controls.
  • The study included 17 surgically closed ASD, 18 percutaneously closed ASD, and 18 control participants.

Conclusions:

  • Adults with ASDs, regardless of closure method (surgical or percutaneous), display impaired HRV.
  • The reduction in HRV is more pronounced in individuals with surgically closed ASDs.
  • These findings suggest a persistent impact on autonomic cardiac regulation following ASD correction.
Abstract

Keywords:
Atrial septal defectCongenital heart diseaseHeart rate variabilityLong-term follow-upSympathovagal imbalance

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