title: Incidence of atrial fibrillation after percutaneous closure of patent foramen ovale and small atrial septal defects in patients presenting with cryptogenic stroke.
abstract: OBJECTIVE
  The occurrence of atrial fibrillation after percutaneous closure of a patent foramen ovale for cryptogenic stroke has been reported in a variable percentage of patients. However, its precise incidence and mechanism are presently unclear and remain to be elucidated.
  
  
  METHODS
  Prospective follow-up study.
  
  
  METHODS
  Ninety-two patients undergoing a percutaneous patent foramen ovale closure procedure (closure group) for cryptogenic stroke were compared with a similar group of 51 patients, who were medically treated.
  
  
  METHODS
  A systematic arrhythmia follow-up protocol to assess the incidence of AF was performed including a 7-day event-loop recording at day 1, after 6 and 12 months in patients of the closure group and compared with those of the medically treated group.
  
  
  RESULTS
  The incidence of AF was similar in both study groups during a follow-up of 12 months, including 7.6% (95% CI: 3.1-15.0%) in the closure and 7.8% (95% CI: 2.18-18.9%) in the medically treated group (P=1.0). The presence of a large patent foramen ovale was the only significant risk factor for the occurrence of AF as demonstrated by a multivariate Cox regression analysis (95% CI, 1.275-20.018; P=0.021).
  
  
  CONCLUSIONS
  Our findings indicate that patients with cryptogenic stroke and patent foramen ovale have a rather high incidence of AF during a follow-up of 12 months. Atrial fibrillation occurred with a similar frequency whether the patent foramen ovale/atrial septal defect was successfully percutaneously closed or was medically managed. The presence of a large patent foramen ovale was the only significant predictor of AF occurrence during follow-up.
authors.affiliation: Cardiology Service, University Hospital, Geneva, Switzerland. robert.bonvini@hcuge.ch
authors.forename: R F
authors.initials: RF
authors.lastname: Bonvini
authors.forename: R
authors.initials: R
authors.lastname: Sztajzel
authors.forename: P-A
authors.initials: PA
authors.lastname: Dorsaz
authors.forename: M
authors.initials: M
authors.lastname: Righini
authors.forename: C
authors.initials: C
authors.lastname: Bonvin
authors.forename: J
authors.initials: J
authors.lastname: Alibegovic
authors.forename: U
authors.initials: U
authors.lastname: Sigwart
authors.forename: E
authors.initials: E
authors.lastname: Camenzind
authors.forename: V
authors.initials: V
authors.lastname: Verin
authors.forename: J
authors.initials: J
authors.lastname: Sztajzel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000453:epidemiology*; D002545:Brain Ischemia / Q000150:complications; D006348:Cardiac Surgical Procedures; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D054092:Foramen Ovale, Patent / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006344:Heart Septal Defects, Atrial / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications* / Q000209:etiology; D014463:Ultrasonography; D055815:Young Adult