Key result
In patients undergoing PFO closure, the incidence of new-onset atrial fibrillation detected by systematic 24-hour ambulatory ECG monitoring within 6 months was low (4.8%).
Why the study?
Randomized trials noted an increased risk of new-onset AF after PFO closure, but without systematic AF screening.
What is the incidence of new-onset atrial fibrillation detected by systematic serial 24-hour AECG monitoring in patients undergoing PFO closure?
Cohort (n=62)
Yes
What is the incidence of new-onset atrial fibrillation detected by systematic serial 24-hour AECG monitoring in patients undergoing PFO closure?
Systematic 24-hour AECG monitoring after PFO closure demonstrated a low (<5%) incidence of new-onset AF, which was typically paroxysmal, asymptomatic, and occurred within the first month.
May reassure on low AF risk post-PFO closure with monitoring; leaves open need for larger prospective studies.
BACKGROUND: Increased risk of new-onset atrial fibrillation (AF) after patent foramen ovale (PFO) closure was observed in randomized trials without however systematic AF screening. We aimed to evaluate the incidence of AF within 6-month following PFO closure with serial 24-hour ambulatory electrocardiogram (AECG) monitoring. METHODS: All patients undergoing PFO closure were prospectively included in 2 centers. AF was defined as irregular rhythm without discernible P waves > 30 s on AECG at day 0, 1-month and 6-month follow-up. Primary endpoint was the incidence of AF within the study period. Secondary endpoints evaluated clinical outcomes within 6-month follow-up. RESULTS: Between February 2018 and March 2019, 62 patients underwent PFO closure including 40 male (64.5%) with a mean age of 48 ± 9.5. Atrial septal aneurysm was observed in 37 patients (64.9%), 57 patients (91.9%) received an Amplatzer Occluder device (Abbott Vascular) and 5 (8.1%) an Occlutech device (Occlutech). After a mean follow-up of 7.7 ± 2.8 months, new-onset AF occurred in 3 patients (4.8%), all within the first month following PFO closure, including one per-procedural, all were asymptomatic and paroxysmal. Two patients with AF (3.2%) required chronic oral anticoagulant therapy. No adverse outcomes occurred at follow-up. No predictive factors of AF were highlighted. A total of 16 patients (25.8%) reported palpitations without AF on the AECGs. CONCLUSION: In highly selected patients, incidence of AF, evaluated with 3 systematic 24-hour AECG within 6-month following PFO closure, was low (<5%). Always paroxysmal, AF occurred within the first month after the procedure and was not associated with adverse outcomes.
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Leclercq et al. (2021) conducted a cohort in Patent foramen ovale (PFO) (n=62). Patent foramen ovale (PFO) closure was evaluated on Incidence of atrial fibrillation within the study period. In patients undergoing PFO closure, the incidence of new-onset atrial fibrillation detected by systematic 24-hour ambulatory ECG monitoring within 6 months was low (4.8%).
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