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Cited by 26Cardiovascular and Diving-Related ComplicationsCongenital Heart Disease StudiesAtrial Fibrillation Management and Outcomes

The importance of pulmonary artery pressures on late atrial arrhythmia in transcatheter and surgically closed ASD type secundum

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De Bruaene, Alexander Van, Delcroix, Marion, Pasquet, Agnes, De Backer, Julie, Paelinck, Bernard, Morissens, Marielle, Budts, Werner·2011·International Journal of Cardiology
DOI 10.1016/j.ijcard.2010.07.014
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Abstract

Aims Atrial fibrillation and flutter remain an important cause of morbidity in adults with atrial septal defect (ASD). This study aimed at investigating predictors for late (≥ 1 month after repair) atrial arrhythmia.Methods Patients who underwent ASD closure after the age of 18 years, were selected through the databases of three medical centres in Belgium. Preprocedural, periprocedural and follow-up data were extracted. Univariate and multivariate Cox-regression analysis was performed. Kaplan-Meier analysis was performed for any independent predictor of late atrial arrhythmia.Results A total of 155 patients (38 men and 117 women) was included. Twenty-four patients (median age 48.3 years, range 19.9-79.8) underwent surgical and 131 (median age 57.6 years, range 18.2-86.9) underwent transcatheter closure. Thirty-nine patients (25.2%) presented with late atrial arrhythmia. Male gender (P = 0.008), creatinine (P = 0.002), atrial arrhythmia before (P < 0.0001) and within 1 month after repair (P = 0.001) and a mean pulmonary artery pressure (mPAP) ≥ 25 mmHg (P < 0.0001) correlated with late atrial arrhythmia in univariate Cox-regression analysis. Multivariate analysis showed that mPAP ≥ 25 mm Hg (HR 3.72; 95%CI 1.82-7.59; P < 0.0001) and the presence of atrial arrhythmia before (HR 3.22; 95%CI 1.56-6.66; P = 0.002) and within 1 month after repair (HR 2.08; 95%CI 2.08-15.92; P = 0.001) were predictive of late atrial arrhythmia. Kaplan-Meier analysis showed that patients with a mPAP ≥ 25 mm Hg had a higher risk at developing late atrial arrhythmia (P < 0.0001).Conclusion In patients with ASD type secundum, a mPAP ≥ 25 mmHg is an independent predictor of late atrial arrhythmia. The presence of pulmonary hypertension before repair should raise awareness for atrial arrhythmias and may be used to guide therapy.

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Authors
De Bruaene, A. V., Delcroix, M., Pasquet, A., De Backer, J., Paelinck, B., Morissens, M., & Budts, W.
Affiliations
  • Universitair Ziekenhuis Leuven (BE)
  • Antwerp University Hospital (BE)
  • Centre Hospitalier Universitaire Brugmann (BE)
ORCID
Venue
International Journal of Cardiology
Publisher
Elsevier BV
Published
2011-10
Volume
152
Issue
2
Pages
192-195
ISSN
0167-5273 (ISSN-L)
DOI
10.1016/j.ijcard.2010.07.014
OpenAlex
W2017252669
Cited by
26
References
35
Citations by year
2023: 1 · 2022: 1 · 2021: 2 · 2020: 3 · 2018: 6 · 2017: 1 · 2016: 7 · 2015: 1 · 2014: 1 · 2012: 1
FWCI
0.80
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion)
  • DIAL (Catholic University of Leuven) (submittedVersion)
  • Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
  • Lirias (KU Leuven) (submittedVersion, other-oa)
Funders
  • Fonds Wetenschappelijk Onderzoek
  • Vlaamse regering
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
  • Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Keywords
atrial septal defect, secundum atrial septal defect, pulmonary artery pressure, atrial fibrillation, atrial flutter, transcatheter closure, surgical closure, adult congenital heart disease, risk factors, creatinine, postoperative arrhythmia prevention, anticoagulation
MeSH terms
Adult, Aged, Aged, 80 and over, Atrial Fibrillation, Female, Follow-Up Studies, Cardiac Catheterization, Heart Septal Defects, Atrial, Humans, Hypertension, Pulmonary, Male, Middle Aged, Postoperative Complications, Multivariate Analysis, Kaplan-Meier Estimate, Septal Occluder Device

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