Key result
Secundum ASD closure improves ECG parameters, cutting QRS duration by ~25 ms with continued long-term declines.
Why the study?
This study aimed to evaluate the short-term (<24 hours) and long-term (>6 months) electrical changes after Secundum ASD closure.
Does percutaneous or surgical closure improve electrocardiographic parameters of electrical remodeling in patients with Secundum atrial septal defect?
Does percutaneous or surgical closure improve electrocardiographic parameters of electrical remodeling in patients with Secundum atrial septal defect?
Interventional closure of Secundum ASD leads to rapid and sustained electrical reverse remodeling as evidenced by significant improvements in ECG parameters.
May support secundum ASD closure for electrical remodeling benefits; extends prior hemodynamic research to electrical parameters.
Background: Secundum atrial septal defect (ASD) is a common congenital cardiac lesion that produces left-to-right shunting and chronic right-sided volume overload, leading to geometric and electrical remodeling. Electrocardiography (ECG) provides a simple, non-invasive method to detect ASD-related electrical abnormalities and to assess reverse remodeling following defect closure. This study aimed to evaluate the short-term (<24 hours) and long-term (>6 months) electrical changes after Secundum ASD closure. Methods: We conducted a prospective, single-center, observational cohort study of Secundum ASD patients who underwent percutaneous or surgical closure at RSUP Dr. Wahidin Sudirohusodo. A total of 54 eligible subjects were included. ECG measurements were performed at admission (pre-closure), within 24 hours post-closure, and at more than 6 months post-closure. ECG parameters were statistically compared using a paired T-test or Wilcoxon signed-rank test. Results: Of the 54 ASD patients, the majority were female (66.7%) and adults (68.5%), with 33 patients (61.1%) undergoing percutaneous closure. Significant reductions were observed across all ECG parameters within 24 hours post-closure, including P-wave amplitude (0.19 ± 0.04 to 0.11 ± 0.03 mV; p<0.001), P-wave duration (97.78 ± 11.94 to 75.35 ± 13.36 ms; p<0.001), PR interval (182.89 ± 26.47 to 156.83 ± 21.81 ms; p<0.001), QRS duration (112.97 ± 14.84 to 88.31 ± 14.43 ms; p<0.001), QRS axis (107.94 ± 23.00 to 95.25 ± 24.62°; p<0.001), QTc interval (403.84 ± 30.85 to 396.80 ± 33.76 ms; p=0.017), and R-wave amplitude in V1 (0.74 ± 0.35 to 0.53 ± 0.24 mV; p<0.001). From <24 hours to >6 months post-closure, most parameters continued to decline significantly, with the exception of P-wave amplitude, which remained stable (p=0.321). Conclusions: Interventional closure of Secundum ASD induces marked electrical reverse remodeling, evident both within hours of the procedure and during long-term follow-up. These findings underscore the value of ECG as an accessible and informative modality for tracking post-intervention cardiac recovery
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Patimang et al. (2025) studied this question. Secundum ASD closure significantly reduced all ECG parameters within 24 hours, including QRS duration (112.97 to 88.31 ms; p<0.001), with most continuing to decline beyond 6 months.
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