open access

Vol 15, No 6 (2008)
Original articles
Published online: 2008-09-22
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Symptomatic tachy- and bradyarrhythmias after transcatheter closure of interatrial communications with Amplatzer devices

Małgorzata Szkutnik, Anna Lenarczyk, Jacek Kusa, Jacek Białkowski
Cardiol J 2008;15(6):510-516.

open access

Vol 15, No 6 (2008)
Original articles
Published online: 2008-09-22

Abstract


Background: The aim of this paper is to present our own experience related to frequency of symptomatic tachy- and bradyarrhythmias in patients after transcatheter closure of interatrial defects (ASD) and patent foramen ovale (PFO) using Amplatzer plugs.
Methods: Transcatheter closure of interatrial communications with Amplatzer devices was carried out on 739 patients in our center. Only patients with new symptomatic arrhythmias (who required pharmacotherapy, cardioversion or pacemaker implantation) were included in to the study. All patients who had had arrhythmias prior to ASD closure, such as supraventricular tachycardias (SVT) or atrial flutter/fibrillation (AF), were excluded.
Results: New tachy- and bradyarrhythmias after implantation of Amplatzer devices were observed in 11 patients (1.5%). There were 9 patients (mean age 36.7 years) with atrial tachyarrhythmias (AF in 8 and SVT in 1 patients), which occurred between the first day and 3 months after implantation. Seven patients were treated initially by pharmacotherapy; in 2 of them sinus rhythm returned just after cardioversion. In other 2 patients cardioversion was performed as an initial therapy. In none of these patients, but one recurrence of tachycardia was observed; however, 7 of them had pharmacotherapy prolonged up to 1 year. In 2 patients, aged 15 and 16, complete atrioventricular (AV) block was observed 4.3 and 1.5 years after Amplatzer implantation, respectively. In the first patient intermittent second-degree AV block (Mobitz II) was observed before ASD closure. In both patients, a DDDR pacemaker was implanted.
Conclusions: Transcatheter closure of ASD using Amplatzer devices is associated with a risk of new atrial tachyarrhythmias (usually early after the procedure and in older patients). The risk of conduction disturbances such as complete heart block, which can occur in late followup, is low. Thence, close long-term follow-up of these patients is obligatory.

Abstract


Background: The aim of this paper is to present our own experience related to frequency of symptomatic tachy- and bradyarrhythmias in patients after transcatheter closure of interatrial defects (ASD) and patent foramen ovale (PFO) using Amplatzer plugs.
Methods: Transcatheter closure of interatrial communications with Amplatzer devices was carried out on 739 patients in our center. Only patients with new symptomatic arrhythmias (who required pharmacotherapy, cardioversion or pacemaker implantation) were included in to the study. All patients who had had arrhythmias prior to ASD closure, such as supraventricular tachycardias (SVT) or atrial flutter/fibrillation (AF), were excluded.
Results: New tachy- and bradyarrhythmias after implantation of Amplatzer devices were observed in 11 patients (1.5%). There were 9 patients (mean age 36.7 years) with atrial tachyarrhythmias (AF in 8 and SVT in 1 patients), which occurred between the first day and 3 months after implantation. Seven patients were treated initially by pharmacotherapy; in 2 of them sinus rhythm returned just after cardioversion. In other 2 patients cardioversion was performed as an initial therapy. In none of these patients, but one recurrence of tachycardia was observed; however, 7 of them had pharmacotherapy prolonged up to 1 year. In 2 patients, aged 15 and 16, complete atrioventricular (AV) block was observed 4.3 and 1.5 years after Amplatzer implantation, respectively. In the first patient intermittent second-degree AV block (Mobitz II) was observed before ASD closure. In both patients, a DDDR pacemaker was implanted.
Conclusions: Transcatheter closure of ASD using Amplatzer devices is associated with a risk of new atrial tachyarrhythmias (usually early after the procedure and in older patients). The risk of conduction disturbances such as complete heart block, which can occur in late followup, is low. Thence, close long-term follow-up of these patients is obligatory.
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Keywords

atrial septal defect; transcatheter closure; arrhythmias

About this article
Title

Symptomatic tachy- and bradyarrhythmias after transcatheter closure of interatrial communications with Amplatzer devices

Journal

Cardiology Journal

Issue

Vol 15, No 6 (2008)

Pages

510-516

Published online

2008-09-22

Bibliographic record

Cardiol J 2008;15(6):510-516.

Keywords

atrial septal defect
transcatheter closure
arrhythmias

Authors

Małgorzata Szkutnik
Anna Lenarczyk
Jacek Kusa
Jacek Białkowski

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