Infl uence of percutaneous transcatheter closure of an atrial septal defect on the atrioventricular conduction

Abstract

Objective This study aimed at determining the eff ect of percutaneous ASD closure on the AV conduction. Percutaneous closure of ostium secundum atrial septal defects (ASDs) has been widely accepted and has become the standard treatment of this malformation. However, some complications have been reported. Because of the close proximity between the discs of the device and the atrioventricular (AV) node, atrioventricular conduction disturbances (AVCD) are a likely complication.Methods and results From the database of congenital heart disease, 46 patients (mean age 54 ± 12 y) who underwent percutaneous ASD closure and 46 patients who underwent a percutaneous patent foramen ovale (PFO) closure were matched according to age, gender and follow-up time. Demographic, clinical, biochemical, and ECG variables were compared.Before closure, the PR interval in the ASD group was signifi cantly longer than in the PFO group (169 ± 22 ms versus 158 ± 25 ms, P= 0.031), which persisted after a mean follow-up time of 4.5 years (180 ± 39 ms versus 163 ± 23 ms, P= 0.007). PR interval increased signifi cantly from closure to latest follow-up in the ASD (P= 0.038), but not in the PFO group (P= 0.058).Conclusions ASD patients presented with signifi cantly longer PR interval than PFO patients before closure. In contrast with the PFO group, the PR interval increased in the ASD group after medium-term follow-up. These fi ndings indicate the need for further follow-up after ASD repair in order to detect potential late AVCD.