Incidence of new-onset atrial fibrillation after transcatheter patent foramen ovale closure using 15 years of Ontario administrative health data

Oliva, Laura; Huszti, Ella; Hall, Ruth; Abrahamyan, Lusine; Horlick, Eric

doi:10.1016/j.hrthm.2022.04.006

Cited by 20 publications

(10 citation statements)

References 26 publications

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“…In addition, we also found that recovery of LASct was slower than recovery of LAScd, indicating that LAScd has a compensatory role when LA function is impaired. was 6.26% following PFO closure [23]. Moreover, a meta-analysis showed that patients who underwent percutaneous PFO closure had a 5-fold increase in risk of AF, which was highest in the rst 45 days after closure [8].…”

Section: Discussionmentioning

confidence: 99%

Changes in left atrial function after percutaneous closure of patent foramen ovale

Qiu

Wang

et al. 2023

Preprint

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Purpose This study aimed to investigate left atrial (LA) function following patent foramen ovale (PFO) closure.Methods Patients with PFO who underwent transcatheter closure between 2015 and 2022 and had complete echocardiography examination data available at baseline and at least twice during 1-year of follow-up were enrolled. LA function was evaluated by measuring LA reservoir strain (LASr), conduit strain (LAScd), and contractile strain (LASct) through speckle-tracking echocardiography. Differences in LA strain between baseline and at the different follow-up times were compared using repeated-measures analysis. The association between risk factors and LA strain was evaluated in a univariable and multivariable linear regression model.Results Forty-five patients were included. After 3 months, we observed a decrease in LASr (from 40.98–33.09%, P < 0.05), which recovered to 37.30% at 6 months (P = 0.06). LAScd decreased significantly from baseline after the procedure (P < 0.05) but had recovered by 3 months (19.96% vs 19.04%, P = 0.06). LASct decreased significantly between baseline and 6 months (from 17.92–14.01%, P < 0.05). All changes resolved by 1 year. Multivariable models showed that LA strain at baseline was the most important factor affecting LA function. LA diameter was significantly associated with sustained changes in LAScd (β = 7.19, P = 0.038). Age was a risk factor for difficult recovery of LASct after PFO at 3 months.Conclusions Implantation of a PFO occluder has a transient adverse impact on LA function in the area adjacent to the device but resolves within 1 year.

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Section: Discussionmentioning

confidence: 99%

Changes in left atrial function after percutaneous closure of patent foramen ovale

Qiu

Wang

et al. 2023

Preprint

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“…The incidence of AF occurring after percutaneous PFO closure due to ischaemic stroke is likely underestimated in randomised trials and literature data, since only symptomatic AF is detected 1 2 5 6 20–22. In patients with systematic investigation of possible AF using Holter ECG monitoring or ICMs, the incidence rises to 20.9% in the 28 days following PFO closure 16 17.…”

Section: Discussionmentioning

confidence: 99%

“…The effect is likely mechanical and should diminish over time. Other independent predictors of AF in this context include age, male sex and diabetes,10 12 16 20 all three also known risk factors for AF 18 19…”

Section: Discussionmentioning

confidence: 99%

Incidence of atrial fibrillation in cryptogenic stroke with patent foramen ovale closure: protocol for the prospective, observational PFO-AF study

Badoz,

Derimay,

Serzian

et al. 2023

BMJ Open

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IntroductionAfter closure of patent foramen ovale (PFO) due to stroke, atrial fibrillation (AF) occurs in up to one in five patients. However, data are sparse regarding the possible pre-existence of AF in these patients prior to PFO closure, and about recurrence of AF in the long term after the procedure. No prospective study to date has investigated these topics in patients with implanted cardiac monitor (ICM). The PFO-AF study (registered with ClinicalTrials.gov under the numberNCT04926142) will investigate the incidence of AF occurring within 2 months after percutaneous closure of PFO in patients with prior stroke. AF will be identified using systematic ICM. Secondary objectives are to assess incidence and burden of AF in the 2 months prior to, and up to 2 years after PFO closure.Methods and analysisProspective, multicentre, observational study including 250 patients with an indication for PFO closure after stroke, as decided by interdisciplinary meetings with cardiologists and neurologists. Patients will undergo implantation of a Reveal Linq device (Medtronic). Percutaneous PFO closure will be performed 2 months after device implantation. Follow-up will include consultation, ECG and reading of ICM data at 2, 12 and 24 months after PFO closure. The primary endpoint is occurrence of AF at 2 months, defined as an episode of AF or atrial tachycardia/flutter lasting at least 30 s, and recorded by the ICM and/or any AF or atrial tachycardia/flutter documented on ECG during the first 2 months of follow-up.Ethics and disseminationThe study was approved by the Ethics Committee ‘Comité de Protection des Personnes (CPP) Sud-Méditerranéen III’ on 2 June 2021 and registered with ClinicalTrials.gov (NCT04926142). Findings will be presented in national and international congresses and peer-reviewed journals.Trial registration numberNCT04926142.

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“…However, AF commonly occurs within 45 days after device implantation, and in 76% of cases is a transient phenomenon without recurrence [ 32 ]. According to a recent retrospective cohort study on 1533 Ontarian patients, the incidence of AF after PFO closure was relatively low (6.26%) over a follow-up of about 8 years [ 33 ].…”

Section: Percutaneous Closure Of Pfo By Traditional Devicesmentioning

confidence: 99%

Advances in Percutaneous Patent Foramen Ovale Closure: From the Procedure to the Echocardiographic Guidance

Sperlongano

Giordano

Ciccarelli

et al. 2022

JCM

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Percutaneous patent foramen ovale (PFO) closure by traditional, double disc occluder devices was shown to be safe for patients with PFO, and more effective than prolonged medical therapy in preventing recurrent thromboembolic events. The novel suture-mediated “deviceless” PFO closure system overcomes most of the risks and limitations associated with the traditional PFO occluders, appearing to be feasible in most interatrial septum anatomies, even if data about its long-term effectiveness and safety are still lacking. The aim of the present review was to provide to the reader the state of the art about the traditional and newer techniques of PFO closure, focusing both on the procedural aspects and on the pivotal role of transesophageal echocardiography (TEE) in patient’s selection, peri-procedural guidance, and post-interventional follow-up.

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Incidence of new-onset atrial fibrillation after transcatheter patent foramen ovale closure using 15 years of Ontario administrative health data

Cited by 20 publications

References 26 publications

Changes in left atrial function after percutaneous closure of patent foramen ovale

Changes in left atrial function after percutaneous closure of patent foramen ovale

Incidence of atrial fibrillation in cryptogenic stroke with patent foramen ovale closure: protocol for the prospective, observational PFO-AF study

Advances in Percutaneous Patent Foramen Ovale Closure: From the Procedure to the Echocardiographic Guidance

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