Dual-Phase Increase in Atrial Arrhythmia Prevalence Following Percutaneous Atrial Septal Defect Closure.

Area of Science:

• Cardiology
• Electrophysiology
• Adult Congenital Heart Disease

Background:

• Conflicting data exist regarding age at percutaneous atrial septal defect (ASD) closure and subsequent atrial arrhythmias (AA) burden in adults.
• Predisposing patient-specific factors influencing AA post-ASD closure require further investigation.

Purpose of the Study:

• To determine the effect of age at ASD closure on the burden of AA post-procedure.
• To identify patient-specific factors associated with AA development after percutaneous ASD closure.

Main Methods:

• Analysis of 197 patients who underwent percutaneous ASD closure between January 2010 and July 2022.
• Utilized a nonlinear logistic temporal decomposition mixed-effects model to analyze longitudinal AA data.
• Included patient demographics, echocardiographic parameters, and rhythm monitoring records.

Main Results:

• Postclosure AA exhibited a dual-phase pattern: early peaking and a late rise up to 6 years.
• Age 60 years or older was linked to higher early and late AA prevalence.
• Older age, lower E/A ratio, lower ejection fraction, tricuspid regurgitation, RV dysfunction, and RV dilation were associated with increased AA likelihood.

Conclusions:

• Older patients experience an ongoing dual-phase risk for AA after percutaneous ASD closure.
• Routine rhythm monitoring is crucial for patients aged 60 years and older post-ASD closure.