Prediction of early-onset atrial tachyarrhythmia after successful trans-catheter device closure of atrial septal defect
Key result
Transient atrial fibrillation or flutter during trans-catheter closure of atrial septal defect significantly increased the risk of early new-onset atrial tachyarrhythmia (HR 9.90).
Population
427 adults with secundum atrial septal defect undergoing trans-catheter closure, median age 37.0, 28.8% male.
Design
Cohort
Follow-up
median 11.4 months
Authors
Discussion
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Implication
Transient AF/AFL during transcatheter ASD closure may warrant closer post-procedural rhythm monitoring; this association leaves open the need for prospective validation of preventive strategies.
Study Design
Type
Observational (n=427)
Multicenter
No
Structured PICO
P
Population
427 adults with secundum atrial septal defect (ASD) undergoing trans-catheter closure, median age 37.0, 28.8% male.
I
Intervention
Trans-catheter device closure of atrial septal defect
O
Outcome
New-onset atrial tachyarrhythmia defined as a composite of atrial fibrillation or flutter (AF/AFL) after ASD closurecomposite
Main Result
Effect estimate: HR 9.90 (95% CI 2.86-34.20)
Absolute Event Rate: 27.3% vs 3.8%
p-value: p=<0.001
Transient AF/AFL during closure, deficient posteroinferior rim, and age over 48 years are significant predictors of early new-onset atrial tachyarrhythmia after trans-catheter ASD closure.
Limitations
- Retrospective study design with potential selection bias.
- Possible underestimation of asymptomatic atrial tachyarrhythmia due to reliance on normal ECG and Holter monitoring.
- Younger age of enrolled patients may have influenced the lower incidence of atrial arrhythmias.
- Serial echocardiographic changes could not be examined as not all patients underwent follow-up echocardiography.
Cite This Study
Park et al. (2016) conducted an observational in Secundum atrial septal defect (n=427). Transient atrial fibrillation or flutter during closure vs. Consistent sinus rhythm during closure was evaluated on New-onset atrial tachyarrhythmia (composite of atrial fibrillation or flutter) (HR 9.90, 95% CI 2.86-34.20, p=<0.001). Transient atrial fibrillation or flutter during trans-catheter closure of atrial septal defect significantly increased the risk of early new-onset atrial tachyarrhythmia (HR 9.90).