Role of atrial fibrillation after transcatheter closure of patent foramen ovale in patients with or without cryptogenic stroke

Bronzetti, Gabriele; D’Angelo, Cinzia; Donti, Andrea; Salomone, Luisa; Giardini, Alessandro; Picchio, Fernando Maria; Boriani, Giuseppe

doi:10.1016/j.ijcard.2009.05.035

Cited by 18 publications

(4 citation statements)

References 32 publications

(36 reference statements)

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“…The incidence of device related new onset atrial arrhythmia is potentially important given the link between atrial arrhythmia and the risk of thrombo‐embolic cerebral events . The incidence of atrial arrhythmia for existing devices following PFO closure varies between 0.6 and 15% depending on the series and the detection methods employed . In this series there was confirmed evidence of new onset atrial dysrhythmia (either atrial flutter or fibrillation) in 2.2% of cases following implant of the GSO.…”

Section: Discussionmentioning

confidence: 66%

Patent foramen ovale closure with the gore septal occluder

Thomson

Hildick‐Smith²,

Clift

et al. 2013

Cathet Cardio Intervent

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Section: Discussionmentioning

confidence: 66%

Patent foramen ovale closure with the gore septal occluder

Thomson

Hildick‐Smith²,

Clift

et al. 2013

Cathet Cardio Intervent

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“…A total of 6 randomized controlled trials [7][8][9][10][11]27 and 26 observational studies [20][21][22][23][24][25][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] were included, comprising 3737 and 9126 patients, respectively. Full characteristics of the included study are detailed in Table III in the Data Supplement.…”

Section: Bias Analysismentioning

confidence: 99%

Atrial Fibrillation Following Patent Foramen Ovale Closure

Chen

Thijs

2021

Stroke

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Background and Purpose: Multiple studies evaluated whether patent foramen ovale (PFO) closure reduces the risk of ischemic stroke. One commonly reported complication of PFO closure is the development of atrial fibrillation (AF), which is itself a powerful stroke risk factor that requires specific management. This study aims to evaluate the frequency of AF in patients post-percutaneous closure of PFO and the clinical factors that predict AF detection. Methods: Studies were identified by systematically searching EMBASE and MEDLINE databases on July 11, 2019. Meta-analysis of proportions was performed, assuming a random-effects model. Results: A total of 6 randomized controlled trials and 26 observational studies were included, comprising 3737 and 9126 patients, respectively. After PFO closure, the rate of AF development was 3.7 patients per 100 patient-years of follow-up (95% CI, 2.6–4.9). The risk of AF development is concentrated in the first 45 days post-procedure (27.2 patients per 100 patient-years [95% CI, 20.1–34.81], compared with 1.3 patients per 100 patient-years [95% CI, 0.3–2.7]) after 45 days. Meta-regression by age suggested that studies with older patients reported higher rate of AF ( P =0.001). In medically treated patients, the rate of AF development was 0.1 per 100 patient-years of follow-up (95% CI, 0.0–0.4). Closure of PFO is associated with increased risk of AF compared with medical management (odds ratio, 5.3 [95% CI, 2.5–11.41]; P <0.001). Conclusions: AF is more common in PFO patients who had percutaneous closure compared with those who were medically treated. The risk of AF was higher in the first 45 days post-closure and in studies that included patients with increased age.

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“…These reports revealed the hazard of AF among patients receiving PFO closure to be at least 3 times as high as that among patients receiving medical therapy (OR= 3.72; and HR= 3.22 in the 2 studies respectively). Multiple plausible explanations include the presence of a residual shunt after device closure , device‐related atrial mechanical stretch , enhancement of atrial automaticity and promoting re‐entry mechanism , and the presence of preclosure silent atrial arrhythmias by Holter monitoring or external loop recorder .…”

Section: Discussionmentioning

confidence: 99%