Key result
Age ≥60 at percutaneous ASD closure is linked to increased early and late atrial arrhythmias.
Why the study?
Conflicting data surround the relationship between age at percutaneous ASD closure and the subsequent burden of atrial arrhythmias, particularly in adults.
Does age and other predisposing factors affect the burden of atrial arrhythmias following percutaneous atrial septal defect closure?
Cohort (n=197)
No
Does age and other predisposing factors affect the burden of atrial arrhythmias following percutaneous atrial septal defect closure?
Patients aged 60 years or older undergoing percutaneous ASD closure face an ongoing dual-phase risk for atrial arrhythmias up to 6 years post-procedure, warranting routine long-term rhythm monitoring.
May support enhanced long-term rhythm monitoring in patients ≥60 years after percutaneous ASD closure; hypothesis-generating and requires prospective confirmation.
Background: Conflicting data surround the relationship between age at percutaneous atrial septal defect (ASD) closure and subsequent burden of atrial arrhythmias (AA), particularly in adults. This study aimed to determine the effect of age at ASD closure and other predisposing patient-specific factors on the burden of AA postpercutaneous ASD closure. Methods: All patients who underwent percutaneous ASD closure at Cleveland Clinic from January 2010 to July 2022 were included. A nonlinear logistic temporal decomposition mixed-effects model was used to analyze the longitudinal AA. Results: Among 197 patients, 63% (125) were female, with a mean age of 40 years (SD, 24 years) at ASD closure. A total of 177 patients (89% of the cohort) had 687 rhythm records. Postclosure AA exhibited a dual-phase pattern: early peaking phase followed by a late rise up to 6 years postclosure. Age 60 years or older was associated with higher likelihood of early (≤6 months) and late (>6 months) AA prevalence. Older age, lower E/A ratio, and lower left ventricular ejection fraction were associated with a higher likelihood of AA post-ASD closure. Greater than moderate tricuspid regurgitation was associated with a higher likelihood of early AA. Mild right ventricular dysfunction and more than moderate right ventricular dilation were associated with a higher likelihood of late AA. Conclusions: Older patients have an ongoing dual-phase risk for AA postpercutaneous ASD closure. Our findings underscore the need for routine rhythm monitoring in patients aged 60 years or older.
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Burke et al. (2025) conducted a cohort in Atrial septal defect (ASD) (n=197). Percutaneous atrial septal defect closure was evaluated on Longitudinal burden and prevalence of atrial arrhythmias (AA) postpercutaneous ASD closure. Age ≥60 years at the time of percutaneous ASD closure was associated with a higher likelihood of early and late atrial arrhythmias among 197 patients followed for up to 6 years.
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