title: Iatrogenic cardiac arrhythmias following transcatheter or surgical closure of atrial septal defect in children.
abstract: BACKGROUND
  Invasive procedures involving the atria may promote the development of iatrogenic cardiac arrhythmias.
  
  
  OBJECTIVE
  To analyse the prevalence of cardiac arrhythmias following transcatheter or cardiosurgical closure of the secundum type atrial septal defect (ASD).
  
  
  METHODS
  The study group consisted of 91 patients, aged 2-18 years with haemodynamically significant ASD who underwent surgical (n=44) or transcatheter (Amplatzer occluder) (n=47) closure of ASD. Standard ECG and Holter ECG recordings, obtained before and after the procedure, were analysed. The follow-up duration ranged from 2.5 to 5.5 years. Cardiac arrhythmias were divided into benign or significant (requiring pharmacological therapy), early or late, and transient or permanent.
  
  
  RESULTS
  Cardiac arrhythmias were detected in 16 (36%) patients who underwent surgery compared with 1 (2.1%) patient who underwent transcatheter ASD closure (p<0.05). In surgically treated patients, arrhythmias were benign in 9 patients, significant in 7 children, early in 15 subjects, late in one patient, transient in 13 children and permanent in 3 subjects. One patient, who underwent transcatheter ASD closure, developed paroxysmal supraventricular tachycardia one day after the procedure, successfully terminated with verapamil.
  
  
  CONCLUSIONS
  Transcatheter closure of ASD is associated with a lower risk of procedure-related arrhythmias than surgical treatment. However, longer follow-up in patients treated with transcatheter procedure is needed in order to draw definite conclusions.
authors.affiliation: Department of Congenital Heart Diseases and Paediatric Cardiology, Silesian Heart Center, Zabrze.
authors.forename: Blandyna
authors.initials: B
authors.lastname: Karwot
authors.forename: Jacek
authors.initials: J
authors.lastname: Białkowski
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Szkutnik
authors.forename: Maria
authors.initials: M
authors.lastname: Zyła-Frycz
authors.forename: Alina
authors.initials: A
authors.lastname: Skiba
authors.forename: Jacek
authors.initials: J
authors.lastname: Kusa
authors.forename: Jacek
authors.initials: J
authors.lastname: Baranowski
authors.forename: Beata
authors.initials: B
authors.lastname: Chodór
authors.forename: Anna
authors.initials: A
authors.lastname: Baranowska
authors.forename: Janusz
authors.initials: J
authors.lastname: Skalski
authors.forename: Bozena
authors.initials: B
authors.lastname: Zeifert
mesh_terms: D000293:Adolescent; D001145:Arrhythmias, Cardiac / Q000453:epidemiology* / Q000209:etiology*; D006328:Cardiac Catheterization / Q000379:methods; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D002404:Catheterization / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D008297:Male; D016896:Treatment Outcome