Key result
Transcatheter ASD closure significantly reduced P dispersion from 49.73 ms to 30.53 ms (P=0.004) and improved right ventricular dimensions over a 6-month follow-up.
Why the study?
Does transcatheter ASD closure improve cardiac electric remodeling in children and adults with secundum ASD?
Observational (n=50)
Does transcatheter ASD closure improve cardiac electric remodeling in children and adults with secundum ASD?
Absolute Event Rate: 30.53% vs 49.73%
p-value: p=0.004
Transcatheter closure of secundum ASD leads to significant improvements in both cardiac chamber dimensions and electrical remodeling parameters at 6-month follow-up.
May indicate electrical remodeling benefits after ASD closure; hypothesis-generating and should not change practice without RCTs.
Purpose: This study aimed to investigate the intermediate- and short-term effects of transcatheter secundum atrial septal defect (ASD) closure on cardiac electric remodeling in children and adults. Methods: Fifty patients with secundum ASD referred for possible transcatheter device closure were subjected to history taking, proper physical examination, electrocardiographic assessment, and transthoracic echocardiographic examination and were evaluated before the ASD closure, 1 day, 3 months, and 6 months after closure. Results: During the 6-month follow-up, electrocardiographic parameters of remodeling were improved. P dispersion decreased from 49.73 ± 9.01 ms to 30.53 ± 5.08 ms (P = 0.004), QT dispersion decreased from 67.60 ± 5.31 to 51.13 ± 5.73 ms (P = 0.003), QRS duration decreased from 134.40 ± 4.97 ms to 116.20 ± 3.47 ms (P = 0.002), and PR interval decreased from 188.87 ± 6.06 ms to 168.00 ± 6.16 ms (P = 0.002). Electric remodeling was associated with remodeling of the cardiac chambers. At the end of follow-up, the right ventricular (RV) end-diastolic dimension decreased from 25.67 ± 5.50 mm to 17.80 ± 2.70 mm (P = 0.001) the left ventricular end-diastolic dimension increased from 33.17 ± 6.44 mm to 37.53 ± 5.15 mm (P = 0.002), mean pulmonary artery pressure decreased from 16.97 ± 3.37 mmHg to 9.22 ± 1.37 mmHg (P = 0.000), and RV systolic pressure decreased from 30.77 ± 4.69 mmHg to 18.8 ± 2.11 mmHg. After 6 months, 93.3% of the patients had normal RV size. Conclusion: Transcatheter ASD device closure leads to a significant improvement in the right-sided chambers' dimension and function and can reverse electrical changes in atrial and ventricular myocardium in children and adults after correcting hemodynamic status in short- and intermediate-term follow-up.
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Mostafa et al. (2017) conducted an observational in Secundum atrial septal defect (n=50). Transcatheter secundum atrial septal defect closure vs. Baseline (before closure) was evaluated on P dispersion (p=0.004). Transcatheter ASD closure significantly reduced P dispersion from 49.73 ms to 30.53 ms (P=0.004) and improved right ventricular dimensions over a 6-month follow-up.
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