Frequency of atrial tachyarrhythmias following transcatheter closure of patent foramen ovale.
BACKGROUND
Transcatheter closure of patent foramen ovale (PFO) in patients with a history of cryptogenic stroke is performed with increasing frequency. However, the long-term effects of these closure devices on atrial tachyarrhythmias (ATs) are not known.


RESULTS
The study population included 71 patients [31 (44%) men, aged 54 +/- 14 years] with PFO, diagnosed by transesophageal echocardiography (TEE), and greater than or equal to 1 cryptogenic stroke (n = 70) or orthodoxia (n = 1). Patients underwent transcatheter closure of PFO using a 28 mm (n = 53) or a 33 mm (n = 18) CardioSEAL closure device (n = 67) or an Amplatzer occluder (n = 4). Five (7%) patients presented with newly diagnosed (n = 4) or recurrent (n = 1) episodes of AT (3 atrial fibrillation and 2 typical atrial flutter) within 1 to 480 days following the procedure, with an average time to onset of 175 +/- 221 days. ATs were more frequent in those who received a 33 mm device than those who received a 28 mm device [4/18 (22%) vs. 1/53 (2%); p < 0.05]. Patients with ATs showed a trend toward a larger left atrium only on apical view (6.5 +/- 1.4 cm vs. 5.1 +/- 0.9 cm; p = 0.05). However, the difference in left atrial size on parasternal view and right atrial size between the 2 groups was not statistically significant (4.5 +/- 1.1 cm vs. 3.7 +/- 0.8 cm and 5.9 +/- 2.4 cm vs. 4.6 +/- 0.7 cm). Conclusion. Compared to the age-matched population, sustained ATs appear to be relatively common following transcatheter closure of PFO. In our series, they seemed to occur more frequently in patients who received larger devices.
Alaeddini
Jamshid
J
Heart Institute of Spokane, Spokane, Washington, USA.
Feghali
Georges
G
Jenkins
Stephen
S
Ramee
Stephen
S
White
Christopher
C
Abi-Samra
Freddy
F
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000009:adverse effects*; D018618:Echocardiography, Doppler, Color; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria; D006344:Heart Septal Defects, Atrial / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants / Q000009:adverse effects; D013610:Tachycardia / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*