Role of atrial fibrillation after transcatheter closure of patent foramen ovale in patients with or without cryptogenic stroke.
BACKGROUND
Atrial fibrillation (AF) after transcatheter closure of patent foramen ovale (PFO) is not a rare complication. However little is known about the effect of atrial septal device implantation on the occurrence of this arrhythmia.


OBJECTIVE
The aim of this study was to evaluate the occurrence of AF in two groups of patients who underwent transcatheter PFO closure: those with a previous cryptogenic stroke and those with other index events respectively.


METHODS
Patient population included 276 patients with documented PFO who underwent percutaneous closure at our institution. Patients were grouped on the basis of two distinct clinical presentations: a) 246 patients with history of previous cryptogenic cerebrovascular ischemic event (CIE) or b) 30 patients with other different index events. AF after PFO closure was detected by 12-lead electrocardiography or by 24-h-Holter monitoring.


RESULTS
During a mean follow-up of 17 months, new-onset AF was documented in 10 patients (4%), all included in the group with a previous cryptogenic CIE, at a mean of 1.6 months post-procedure. Comparing patients with and without AF, age (mean 56 years vs 46 years, p = 0.012) and left atrial size (4.4 cm vs 3.7 cm, p = 0.001) resulted to differ significantly. The type and size of occluder devices do not seem to impact the occurrence of AF after PFO closure.


CONCLUSIONS
In patients presenting with cryptogenic stroke, especially in those with slightly enlarged left atria and age above 50–55 years, detection of a PFO should prompt an extended monitoring for excluding AF.
Bronzetti
Gabriele
G
Pediatric Cardiology and Adult Congenital Unit, University of Bologna, Bologna, Italy.
D'Angelo
Cinzia
C
Donti
Andrea
A
Salomone
Luisa
L
Giardini
Alessandro
A
Maria Picchio
Fernando
F
Boriani
Giuseppe
G
D000328:Adult; D001281:Atrial Fibrillation / Q000150:complications* / Q000453:epidemiology*; D006328:Cardiac Catheterization / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D054092:Foramen Ovale, Patent / Q000150:complications / Q000453:epidemiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000453:epidemiology*