Atrial fibrillation following device closure of patent foramen ovale.
OBJECTIVE
Recurrent embolic events after device closure of patent foramen ovale (PFO) have been related to incomplete closure. Another cause could be atrial fibrillation (AF). The aim of this study was to determine the incidence of AF in stroke patients after PFO closure.


METHODS
Consecutive patients with device closure of a PFO after a stroke or transient ischemic attack and control patients with stroke underwent 7-day event loop recordings 3 and 6 months after PFO closure or stroke, respectively.


RESULTS
Forty patients treated by PFO device closure 96 +/- 68 days after cryptogenic ischemic stroke and 70 control patients with ischemic stroke of other etiologies (known AF excluded) were compared. AF was identified in 6 patients (15%) of the treated group and in 12 control patients (17%, p = 0.77). In multivariate analysis, the presence of an occluder device was not an independent risk factor for AF.


CONCLUSIONS
The incidence of AF is high after device closure of a PFO in stroke patients and similar to that in patients with stroke of non-PFO etiology and, hence, with no device. Further studies are required to determine the risk of thromboembolism and the optimal treatment in patients developing AF after device closure of a PFO.
Burow
Annika
A
Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland.
Schwerzmann
Markus
M
Wallmann
Dieter
D
Tanner
Hildegard
H
Sakata
Takao
T
Windecker
Stephan
S
Meier
Bernhard
B
Delacrétaz
Etienne
E
D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology*; D016022:Case-Control Studies; D015716:Electrocardiography, Ambulatory; D005260:Female; D054092:Foramen Ovale, Patent / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D011446:Prospective Studies; D020521:Stroke / Q000601:surgery*; D013557:Switzerland / Q000453:epidemiology