Park et al identified risk factors for early new onset of an atrial tachyarrhythmia following trans-catheter device closure of an atrial septal defect (ASD). These can help to identify a patient who may benefit from closer monitoring. The authors are from Samsung Medical Center and Sungkyunkwan University in Seoul.
Patient selection: trans-catheter device closure of an atrial septal defect (secundum type)
Exclusion: prior diagnosis of atrial fibrillation or flutter; more than moderate degree tricuspid or mitral valve regurgitation; without regular Holter monitoring
Outcome: early new onset of an atrial tachyarrhythmia (atrial fibrillation or flutter). The follow-up period was 2 years. The arrhythmia was considered new if it appeared > 30 days after closure.
Risk factors from multivariate analysis:
(1) age > 48 years at time of ASD closure (odds ratio 3.3)
(2) deficient posteroinferior rim of the ASD (rim length < 5 mm; odds ratio 5.5)
(3) transient atrial fibrillation or flutter during closure (odds ratio 9.8)
A procedure time >= 75 minutes had an odds ratio of 2.7 and p=0.06.
The onset of the atrial tachyarrhythmia tended to be early (within first 2 months of closure) for transient fibrillation or flutter and for deficient posteroinferior rim. Onset related to older age tends to occur within 9 months of closure.
