Risk Factors for Atrial Fibrillation in Adult Patients in Long-Term Observation Following Surgical Closure of Atrial Septal Defect Type II

Piechowiak, Monika; Banach, Maciej; Ruta, Jan; Barylski, Marcin; Rysz, Jacek; Bartczak, Karol; Markuszewski, Leszek; Zasłonka, Janusz; Goch, Jan Henryk

doi:10.1055/s-2006-923955

Cited by 12 publications

(10 citation statements)

References 5 publications

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“…P-wave duration, both before and after closure, was significantly longer in patients who had experienced atrial fibrillation than in those who had not. This harmonises with a recent report on adults with ASD using signal-averaged Pwave analysis, although only after surgical ASD closure, in which postoperative P-wave duration was proved to be a risk factor for the occurrence of postoperative AF [19].…”

Section: Discussionsupporting

confidence: 90%

Atrial myocardial pathoelectrophysiology in adults with a secundum atrial septal defect is unaffected by closure of the defect. A study using high resolution signal-averaged orthogonal P-wave technique

Thilén¹,

Carlson²,

Platonov³

et al. 2009

International Journal of Cardiology

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Section: Discussionsupporting

confidence: 90%

Atrial myocardial pathoelectrophysiology in adults with a secundum atrial septal defect is unaffected by closure of the defect. A study using high resolution signal-averaged orthogonal P-wave technique

Thilén¹,

Carlson²,

Platonov³

et al. 2009

International Journal of Cardiology

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“…Eleven studies7 13–20 23 29 30 32 reported AT prevalence at mid-term follow-up (30 days–5 years), with an OR of 0.47 (95% CI 0.36 to 0.62). Eleven studies4 21 22 25–28 31 33 34 reported the results of long-term follow-up (>5 years). In these, the effect of ASD closure on AT prevalence was not significant (OR 0.84, 95% CI 0.65 to 1.07).…”

Section: Resultsmentioning

confidence: 99%

“…This table also shows the ‘quality score’ assigned, based on the number of factors matched. Ten studies matched ≥4 factors scoring 3 points for quality 13 16 17 20 21 23 25 27 34 35. In this group the OR for prevalence of post-closure AT was 0.70 (95% 0.51 to 0.97).…”

Section: Resultsmentioning

confidence: 99%

Atrial septal defect closure is associated with a reduced prevalence of atrial tachyarrhythmia in the short to medium term: a systematic review and meta-analysis

Vecht

Saso

Rao

et al. 2010

Heart

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Atrial tachyarrhythmias are a common complication of atrial septal defects. The objective was to determine the effect of atrial septal defect closure on pre-existing atrial tachyarrhythmias and to investigate if such an effect is present after either surgical or percutaneous closure. Medline, EMBASE, Cochrane Library, and Google Scholar databases were searched between 1967 and 2009. The search was expanded using the 'related articles' function and reference lists of key studies. All studies reporting pre- and post- closure incidence (or prevalence) of atrial tachyarrhythmias in the same patient groups were included. Data were independently extracted by two authors according to a pre-defined protocol. Incongruities were settled by consensus decision. Twenty six studies were identified including 1841 patients who underwent surgical closure and 945 who underwent percutaneous closure. Meta-analysis using a random effects model demonstrated a reduction in the prevalence of atrial tachyarrhythmias following atrial septal defect closure [OR = 0.66 (95% CI 0.57-0.77)]. This effect was demonstrated after both percutaneous [OR = 0.49 (95% CI 0.32-0.76)] and surgical closure [OR = 0.72 (95% CI 0.60-0.87)]. Immediate (<30 days) and mid-term (30 days - 5 years) follow-up also demonstrated a reduction in AT prevalence [ORs of 0.80 (95% CI 0.66-0.97) and 0.47 (95% CI 0.36-0.62) respectively]. Atrial septal defect closure, whether surgical or percutaneous, is associated with a reduction in the post-closure prevalence of pre-existing atrial tachyarrhythmias and atrial fibrillation in the short to medium term.

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“…General factors include older age, male gender, obesity, preexisting congestive heart failure, chronic renal failure, or COPD which are all risk factors for POAF [12, 13]. In noncardiothoracic surgery, predictors for POAF are preexisting valvular disease and asthma, intra-abdominal and major vascular procedures, and intraoperative hypotension [14].…”

Section: Introductionmentioning

confidence: 99%

Postoperative Atrial Fibrillation

2011

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Postoperative atrial fibrillation (POAF) is common among surgical patients and associated with a worse outcome. Pathophysiology of POAF is not fully disclosed, and several perioperative factors could be involved. Direct cardiac stimulation from perioperative use of catecholamines or increased sympathetic outflow from volume loss/anaemia/pain may play a role. Metabolic alterations, such as hypo-/hyperglycaemia and electrolyte disturbances, may also contribute to POAF. Moreover, inflammation, both systemic and local, may play a role in its pathogenesis. Strategies to prevent POAF aim at reducing its incidence and ameliorate global outcome of surgical patients. Nonpharmacological prophylaxis includes an adequate control of postoperative pain, the use of thoracic epidural analgesia, optimization of perioperative oxygen delivery, and, possibly, modulation of surgery-associated inflammatory response with immunonutrition and antioxidants. Perioperative potassium and magnesium depletion should be corrected. The impact of those interventions on patients outcome needs to be further investigated.

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Risk Factors for Atrial Fibrillation in Adult Patients in Long-Term Observation Following Surgical Closure of Atrial Septal Defect Type II

Abstract: PWD may independently predict postoperative AF in long-term follow-up after surgical correction of ASD t.II.

Cited by 12 publications

References 5 publications

Atrial myocardial pathoelectrophysiology in adults with a secundum atrial septal defect is unaffected by closure of the defect. A study using high resolution signal-averaged orthogonal P-wave technique

Atrial myocardial pathoelectrophysiology in adults with a secundum atrial septal defect is unaffected by closure of the defect. A study using high resolution signal-averaged orthogonal P-wave technique

Atrial septal defect closure is associated with a reduced prevalence of atrial tachyarrhythmia in the short to medium term: a systematic review and meta-analysis

Postoperative Atrial Fibrillation

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