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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Factors Determining Occurrence of Arrhythmias in Patients Post-closure of Atrial Septal Defects
Nouran M Mansour1, Raghda G El Sheikh1, Ayman M Elsaeid1
1Cardiovascular Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Insights
Identifying risk factors for arrhythmias after atrial septal defect closure is crucial. Age, P wave dispersion, right ventricle function, and pulmonary artery pressure are key predictors of post-procedural arrhythmias.
Area of Science:
- Cardiology
- Cardiac Surgery
- Electrophysiology
Background:
- Atrial septal defect (ASD) is a common congenital heart defect.
- Closure of ASD can be achieved through transcatheter or surgical methods.
- Arrhythmias are potential complications following ASD closure.
Purpose of the Study:
- To identify risk factors for arrhythmias after transcatheter or surgical ASD closure.
- To investigate the association between patient characteristics and post-procedural arrhythmias.
Main Methods:
- Prospective study of 150 patients undergoing ASD closure.
- Transthoracic echocardiography and 12-lead ECG performed during follow-up.
- Statistical analysis including paired T, chi-square, and logistic regression tests.
Main Results:
- 123 patients had percutaneous closure, 27 had surgical closure.
- Supraventricular arrhythmias occurred in 11 patients post-closure.
- Multivariate analysis identified age, P wave dispersion, RV systolic myocardial velocity, and systolic pulmonary artery pressure as independent risk factors.
Conclusions:
- Age, P wave dispersion, RV systolic myocardial velocity, and systolic pulmonary artery pressure are independent predictors of arrhythmias after ASD closure.
- These factors can aid in risk stratification and patient management.
Objectives:
This study aimed to determine the risk factors for the occurrence of arrhythmias after either transcatheter or surgical closure of atrial septal defect.
Methods:
This prospective study included 150 patients admitted for transcatheter or surgical closure of atrial septal defect. Transthoracic echocardiography together with a twelve-leads ECG were done during 1 and 3 months follow up. The paired T, chi-square and Logistic regression tests were used to detect any association between any arrhythmias and factors that may affect its occurrence.
Results:
One-hundred and twenty-three patients had percutaneous device closure while the remaining 27 patients had surgical closure. The youngest and oldest of the studied patients being 3 & 50 years old respectively with female (108) over male (42) predominance in incidence. After closure, 8 patients at one month and another 3 patients at three months follow up out of the total 150 patients had supraventricular arrhythmias in the form of frequent premature atrial contractions (6 patients), atrioventricular nodal re-entrant tachycardia (2 patients), and paroxysmal Atrial fibrillation (3 patients). No conduction abnormalities nor ventricular arrhythmias occurred. Multivariate analysis showed that age, P wave dispersion, systolic myocardial velocity of right ventricle, and systolic pulmonary artery pressure were independently associated with the occurrence of atrial arrhythmia after atrial septal defect repair.
Conclusion:
Age, P wave dispersion, Systolic pulmonary artery pressure, and systolic myocardial velocity of the right ventricle are independent risk factors to develop arrythmias in patients after atrial septal defect closure.
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