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Updated: Jan 28, 2026
10:52
Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
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Incidence of Atrial Fibrillation Post Patent Foramen Ovale (PFO) Closure: A Meta-analysis
Panagiota Spyropoulou1, Panagiotis Theofilis2, Petros G Mantzios1
13rd Department of Cardiology, Thoracic Diseases General Hospital 'Sotiria', National and Kapodistrian University of Athens, 11527 Athens, Greece.
Current Cardiology Reviews
|January 27, 2026
Summary
Patent foramen ovale (PFO) closure increases early atrial fibrillation or flutter (AF/Af) risk compared to medical therapy. However, these events are usually temporary and not age-dependent, warranting careful consideration against stroke prevention benefits.
Area of Science:
- Cardiology
- Interventional Cardiology
- Neurology
Background:
- Transcatheter patent foramen ovale (PFO) closure is a primary treatment for cryptogenic stroke in select patients.
- Atrial fibrillation or flutter (AF/Af) is a known complication following PFO closure procedures.
- Understanding the incidence and characteristics of AF/Af post-PFO closure is crucial for patient management.
Purpose of the Study:
- To evaluate the incidence of AF/Af after PFO closure versus medical therapy.
- To determine the timing of AF/Af occurrence post-procedure.
- To investigate the influence of patient age on AF/Af development after PFO closure.
Main Methods:
- A systematic literature search was performed in MEDLINE (PubMed) and Scopus.
- Included studies compared AF/Af incidence post-PFO closure to medical therapy.
- Meta-analysis was conducted on a subset of the identified studies.
Main Results:
- PFO closure was associated with a significantly higher risk of developing AF/Af (RR: 2.27).
- A trend towards increased AF/Af rates was observed within the first month post-PFO closure.
- No significant difference in AF/Af rates was found after one month, and age did not impact the primary endpoint.
Conclusions:
- PFO closure elevates short-term AF/Af risk, likely due to procedural factors, but these events are often transient.
- The occurrence of AF/Af post-PFO closure is generally age-independent.
- Standardized monitoring is necessary to accurately assess AF/Af risk and should be weighed against stroke prevention benefits.
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