Lower patent foramen ovale detection with transthoracic echocardiography in atrial fibrillation.
BACKGROUND
Patent foramina ovale (PFO) are small defects within the atrial septum that may play a role in paradoxical embolism, stroke and migraines. The relationship between PFO and atrial fibrillation (AF) has not been formally studied. We prospectively studied patients with a history of AF, versus those without (controls), in order to compare PFO prevalence among them.


METHODS
Sixty-one patients with AF and forty-one controls completed the study, all undergoing transthoracic echocardiography using agitated saline microbubbles and a Valsalva maneuver.


RESULTS
In the control group, 12/41 participants (29.2%) had PFOs compared to 5/61 (8.2%) in the AF group (P < 0.01). PFO positive patients within the entire study population demonstrated greater leftward inter-atrial septal shifting (82% vs 49%, P < 0.05). There was also reduced leftward inter-atrial septal shift observed within the AF group compared to controls (32/61 (52%) vs 31/41 (76%), P < 0.05).


CONCLUSIONS
This study is the first to demonstrate an apparent lower rate of PFO in patients with AF, using bubble contrast echocardiography.
Attaran
Robert R
RR
Sarver Heart Center, University of Arizona Affiliated Hospitals, Tucson, AZ, USA.
Baweja
Gary
G
Foster
Laura
L
Butman
Sam
S
Sorrell
Vincent L
VL
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004452:Echocardiography; D005260:Female; D054092:Foramen Ovale, Patent / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014636:Valsalva Maneuver