Management of patent foramen ovale; findings from a nationwide survey

Apostolos, Anastasios; Drakopoulou, Maria; Trantalis, Georgios; Ioakeimidis, Michael; Koroboki, Eleni; Tsalamandris, Sotirios; Aggeli, Constantina; Ntaios, Georgios; Tsioufis, Costas; Tsivgoulis, Georgios; Toutouzas, Konstantinos

doi:10.1016/j.jstrokecerebrovasdis.2023.107551

Cited by 2 publications

(2 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 51 However, current rhythm monitoring in clinical practice is significantly shorter. 52 , 53 Only for patients having intracardiac loop recorder for a reasonable time period after stroke, we could assure that AF onset is new (Figure 4 ).…”

Section: Pathophysiologymentioning

confidence: 99%

Atrial Fibrillation After Patent Foramen Ovale Closure: Incidence, Pathophysiology, and Management

Apostolos,

Tsiachris,

Drakopoulou

et al. 2024

JAHA

Self Cite

View full text Add to dashboard Cite

This comprehensive review explores the incidence, pathophysiology, and management of atrial fibrillation (AF) following percutaneous closure of patent foramen ovale (PFO). Although AF is considered a common adverse event post PFO closure, its incidence, estimated at <5%, varies based on monitoring methods. The review delves into the challenging task of precisely estimating AF incidence, given subclinical AF and diverse diagnostic approaches. Notably, a temporal pattern emerges, with peak incidence around the 14th day after closure and a subsequent decline after the 45th day, mimicking general population AF trends. The pathophysiological mechanisms behind post PFO closure AF remain elusive, with proposed factors including local irritation, device‐related interference, tissue stretch, and nickel hypersensitivity. Management considerations encompass rhythm control, with flecainide showing promise, and anticoagulation tailored to individual risk profiles. The authors advocate for a personalized approach, weighing factors like age, comorbidities, and device characteristics. Notably, postclosure AF is generally considered benign, often resolving spontaneously within 45 days, minimizing thromboembolic risks. Further studies are required to refine understanding and provide evidence‐based guidelines.

show abstract

Section: Pathophysiologymentioning

confidence: 99%

Atrial Fibrillation After Patent Foramen Ovale Closure: Incidence, Pathophysiology, and Management

Apostolos,

Tsiachris,

Drakopoulou

et al. 2024

JAHA

Self Cite

View full text Add to dashboard Cite

show abstract

“…PFO closure is not suggested in cases without a previous PFO-associated stroke [ 20 ]. Such discrepancies in the management of patients with thrombophilia and PFO-related strokes are well depicted in physicians-based surveys [ 103 ].…”

Section: Thrombophiliamentioning

confidence: 99%

Patent Foramen Ovale Closure in Special Clinical Situations: More Questions Than Answers?

Apostolos,

Alexiou,

Papanikolaou

et al. 2024

Life

Self Cite

View full text Add to dashboard Cite

Patent foramen ovale (PFO) is a remnant of the foetal circulation resulting from incomplete occlusion of the septum primum and septum secundum. Although prevalent in about 25% of the population, it mainly remains asymptomatic. However, its clinical significance in situations such as cryptogenic stroke, migraine, and decompression illness (DCI) has been well described. Recent randomised clinical trials (RCTs) have demonstrated the efficacy of percutaneous PFO closure over pharmacological therapy alone for secondary stroke prevention in carefully selected patients. Notably, these trials have excluded older patients or those with concurrent thrombophilia. Furthermore, the role of closure in other clinical conditions associated with PFO, like decompression sickness (DCS) and migraines, remains under investigation. Our review aims to summarise the existing literature regarding epidemiology, pathophysiological mechanisms, optimal management, and closure indications for these special patient groups.

show abstract

Management of patent foramen ovale; findings from a nationwide survey

Cited by 2 publications

References 29 publications

Atrial Fibrillation After Patent Foramen Ovale Closure: Incidence, Pathophysiology, and Management

Atrial Fibrillation After Patent Foramen Ovale Closure: Incidence, Pathophysiology, and Management

Patent Foramen Ovale Closure in Special Clinical Situations: More Questions Than Answers?

Contact Info

Product

Resources

About