Supraventricular Arrhythmia Following Patent Foramen Ovale Percutaneous Closure.
JACC Cardiovasc Interv
; 15(22): 2315-2322, 2022 11 28.
Article
em En
| MEDLINE
| ID: mdl-36008269
ABSTRACT
BACKGROUND:
Randomized studies have reported low rates of atrial fibrillation (AF) after patent foramen ovale (PFO) closure (<6%) but have relied on patient-reported symptomatic episodes, so the true incidence and timing of AF after PFO closure remain unknown.OBJECTIVES:
The aim of this study was to prospectively determine the incidence, timing, and determinants of supraventricular arrhythmia following PFO closure on the basis of loop recorder monitoring.METHODS:
Cardiac monitoring was proposed to all patients after PFO closure from June 2018 to October 2021 at a single center by means of implantable loop recorder monitoring in patients considered at higher risk for AF (age ≥ 55 years, associated cardiovascular risk factors, prior palpitations, or documented supraventricular ectopic activity) or 4-week external loop recorder monitoring in other patients. The primary endpoint was the incidence of AF, atrial flutter, or supraventricular tachycardia lasting >30 seconds within 28 days of the procedure. Determinants of the primary endpoint were assessed using a stepwise logistic regression model.RESULTS:
A total of 225 patients were included. The primary endpoint occurred in 47 patients (20.9%), including 13 (9.9%) and 24 (28.9%) among patients monitored with external loop recorders and implantable loop recorders, respectively. Overall, the median delay from procedure to arrhythmia was 14.0 days (IQR 6.5-19.0 days), and one-half of these patients reported symptomatic episodes. Determinants of the primary endpoint were older age (adjusted OR 1.67 per 10-year increase; 95% CI 1.18-2.36), device left disc diameter ≥25 mm (adjusted OR 2.67; 95% CI 1.19-5.98) and male sex (adjusted OR 4.78; 95% CI 1.96-11.66).CONCLUSIONS:
Using loop recorder monitoring for ≥28 days, supraventricular arrhythmia was diagnosed in 1 in 5 patients, with a median delay of 14 days, suggesting that this postprocedural event has so far been underestimated.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Flutter Atrial
/
Acidente Vascular Cerebral
/
Forame Oval Patente
/
Dispositivo para Oclusão Septal
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article