Pacemaker and conduction disturbances in patients with atrial septal defect

Abstract

<jats:title>Abstract</jats:title><jats:sec id="S1047951120001365_as1" sec-type="other"><jats:title>Objective:</jats:title><jats:p>To determine the prevalence of pacemaker and conduction disturbances in patients with atrial septal defects.</jats:p></jats:sec><jats:sec id="S1047951120001365_as2" sec-type="other"><jats:title>Design:</jats:title><jats:p>All patients with an atrial septal defect born before 1994 were identified in the Danish National Patient Registry, and 297 patients were analysed for atrioventricular block, bradycardia, right bundle branch block, left anterior fascicular block, left posterior fascicular block, pacemaker, and mortality. Our results were compared with pre-existing data from a healthy background population. Further, outcomes were compared between patients with open atrial septal defects and atrial septal defects closed by surgery or transcatheter.</jats:p></jats:sec><jats:sec id="S1047951120001365_as3" sec-type="other"><jats:title>Results:</jats:title><jats:p>Most frequent findings were incomplete right bundle branch block (40.1%), left anterior fascicular block (3.7%), atrioventricular block (3.7%), and pacemaker (3.7%). Average age at pacemaker implantation was 32 years. Patients with defects closed surgically or by transcatheter had an increased prevalence of atrioventricular block (p &lt; 0.01), incomplete right bundle branch block (p &lt; 0.01), and left anterior fascicular block (p = 0.02) when compared to patients with unclosed atrial septal defects. At age above 25 years, there was a considerably higher prevalence of atrioventricular block (9.4% versus 0.1%) and complete right bundle branch block (1.9% versus 0.4%) when compared to the background cohorts.</jats:p></jats:sec><jats:sec id="S1047951120001365_as4" sec-type="other"><jats:title>Conclusions:</jats:title><jats:p>Patients with atrial septal defects have a considerably higher prevalence of conduction abnormalities when compared to the background population. Patients with surgically or transcatheter closed atrial septal defects demonstrated a higher demand for pacemaker and a higher prevalence of atrioventricular block, incomplete right bundle branch block, and left anterior fascicular block when compared to patients with unclosed atrial septal defects.</jats:p></jats:sec>

Atrial Septal Defect & Patent Foramen Ovale: Features of Ultrasound Diagnostics, Treatment and Monitoring in Children at the Present Stage

“…К таким критическим факторам относят: перенесенный инсульт, наличие фибрилляции предсердий, тромбофилию, тромбоэмболию легочной артерии в анамнезе, мигрень, занятие дайвингом (подводным плаванием), наличие синдрома платипноэ-ортодеоксии (одышка и низкая сатурация кислорода в вертикальном положении, но без симптомов в положении лежа) [36][37][38]. В настоящее время наиболее авторитетной в мире публикацией по данному направлению является SCAI (Society for Cardiovascular Angiography & Interventions) Guidelines for the Management of Patent Foramen Ovale (2019-2022) [39,40].…”

Arrhythmic Risk and Treatment after Transcatheter Atrial Septal Defect Closure

“…On the other hand, atrioventricular block post-transcatheter closure of ASD occurs in rare instances, and it can be transient or may progress to complete heart block [ 15 ]. When compared with patients with unclosed ASD, Albaek et al showed that those with interventional ASD closure were at higher risk of developing atrioventricular block, incomplete right bundle branch block, or left anterior fascicular block and had a higher demand for pacemaker implantation [ 16 ].…”

Treatment of arrhythmia disorders in the adult with congenital heart disease: A lesion-specific review

“…Patients with repaired atrial septal defect (ASD) and atrioventricular septal defect (AVSD) are at increased risk of sinus node dysfunction and heart block, and pacemaker implantation is thus common [57,58]. CS anatomy is abnormal, and it is frequently absent or with atretic ostia [59].…”