Electrocardiographic changes and arrhythmias following percutaneous atrial septal defect and patent foramen ovale device closure

Jonathan N. Johnson, Michelle L. Marquardt, Michael John Ackerman, Samuel J Asirvatham, Guy S. Reeder, Allison K. Cabalka, Frank Cetta, Donald J. Hagler

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Objectives: To compare pre- and post-procedure electrocardiograms (ECGs) in a large cohort of patients after percutaneous closure of atrial septal defect (ASD) and patent foramen ovale (PFO). Background: Percutaneous device closure of ASD or PFO is commonplace. Conduction and rhythm anomalies associated with percutaneous device placement have been reported. Methods: We reviewed records for all patients who underwent percutaneous device closure of ASD or PFO at our institution from 1999 to 2008. Pre-procedure ECG and Holter studies were compared to available short term (<2 months after placement) and intermediate follow-up (>2 months) ECG or Holter. Results: Pre- and post-procedural ECGs were available in 610 patients (305 females, average age 50 ± 18.1 years, range 1-91 years, 384 PFO, 184 ASD, 42 with multiple defects, mean device size 16 mm, range 5-38 mm). We report an incidence of 5.2% (32/610) of arrhythmias in the 4 months following device placement, including 29 patients with atrial tachyarrhythmias (ATs, 22 fibrillation, 7 flutter), 1 with junctional tachycardia, and 2 with heart block. Among other findings, the average P-wave duration was increased on intermediate follow-up as compared to early follow-up (P < 0.001). Development of new-onset 1st degree AV Block after the procedure was associated with an increased risk of ATs post-procedure (P < 0.0001). Conclusion: We report a low risk of clinically significant post-procedure arrhythmias after device placement. Clinically significant heart block occurred in only two patients (0.3%). Changes in several markers of atrial conduction were found, suggesting an effect of device closure on intra-atrial conduction.

Original languageEnglish (US)
Pages (from-to)254-261
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume78
Issue number2
DOIs
StatePublished - Aug 1 2011

Fingerprint

Patent Foramen Ovale
Atrial Heart Septal Defects
Cardiac Arrhythmias
Equipment and Supplies
Electrocardiography
Heart Block
Tachycardia
Atrioventricular Block
Incidence

Keywords

  • atrial fibrillation
  • atrial septal defect
  • atrial tachyarrhythmias
  • device
  • electrocardiography
  • patent foramen ovale

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Electrocardiographic changes and arrhythmias following percutaneous atrial septal defect and patent foramen ovale device closure. / Johnson, Jonathan N.; Marquardt, Michelle L.; Ackerman, Michael John; Asirvatham, Samuel J; Reeder, Guy S.; Cabalka, Allison K.; Cetta, Frank; Hagler, Donald J.

In: Catheterization and Cardiovascular Interventions, Vol. 78, No. 2, 01.08.2011, p. 254-261.

Research output: Contribution to journalArticle

Johnson, Jonathan N. ; Marquardt, Michelle L. ; Ackerman, Michael John ; Asirvatham, Samuel J ; Reeder, Guy S. ; Cabalka, Allison K. ; Cetta, Frank ; Hagler, Donald J. / Electrocardiographic changes and arrhythmias following percutaneous atrial septal defect and patent foramen ovale device closure. In: Catheterization and Cardiovascular Interventions. 2011 ; Vol. 78, No. 2. pp. 254-261.
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AU - Reeder, Guy S.

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AU - Cetta, Frank

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