Association of Interatrial Septal Abnormalities with Cardiac Impulse Conduction Disorders in Adult Patients: Experience from a Tertiary Center in Kosovo

Abstract

Interatrial septal disorders, which include: atrial septal defect, patent foramen ovale and atrial septal aneurysm, are frequent congenital anomalies found in adult patients. Early detection of these anomalies is important to prevent their hemodynamic and/or thromboembolic consequences. The aims of this study were: to assess the association between impulse conduction disorders and anomalies of interatrial septum; to determine the prevalence of different types of interatrial septum abnormalities; to assess anatomic, hemodynamic, and clinical consequences of interatrial septal pathologies. Fifty-three adult patients with impulse conduction disorders and patients without ECG changes but with signs of interatrial septal abnormalities, who were referred to our center for echocardiography, were included in a prospective transesophageal echocardiography study. Interatrial septal anomalies were detected in around 85% of the examined patients. Patent foramen ovale was encountered in 32% of the patients, and in combination with atrial septal aneurysm in an additional 11.3% of cases. Atrial septal aneurysm and atrial septal defect were diagnosed with equal frequency in 20.7% of our study population. Impulse conduction disorders were significantly more suggestive of interatrial septal anomalies than clinical signs and symptoms observed in our patients (84.91% vs 30.19%, P=0.002). Right bundle branch block was the most frequent impulse conduction disorder, found in 41 (77.36%) cases. We conclude that interatrial septal anomalies are highly associated with impulse conduction disorders, particularly with right bundle branch block. Impulse conduction disorders are more indicative of interatrial septal abnormalities in earlier stages than can be understood from the patient’s clinical condition.

Conducting defect with atrial septal aneurysm in a preterm neonate: A case report from resource limited setting

“…Several reports have shown possible association of Right Bundle Branch Block (RBBB) and ASA 6,7 but few or no data in medical literature have reported association between ASA and Congenital Conducting defect (CD).…”

“…There are many evidences associating Atrial Septal Aneurysm (ASA) and cardiac impulse conduction disorder 6,7 . Several reports have shown possible association of Right Bundle Branch Block (RBBB) and ASA 6,7 but few or no data in medical literature have reported association between ASA and Congenital Conducting defect (CD).…”

Correlation of electrocardiogram parameters and hemodynamic outcomes in patients with isolated secundum atrial septal defects

“…The rSR’ pattern in precordial leads V1 or V2 on electrocardiogram (ECG) is a described pattern in patients with hemodynamically significant ASDs, with a reported prevalence of 43%–78% [ Figure 1 ]. [ 12 13 14 15 16 17 ] This pattern is rarely described in normal patients as well. This rSR’ pattern is hypothesized to correlate with RV enlargement rather than a conduction disturbance.…”

“…[121314151617] This pattern is rarely described in normal patients as well. This rSR’ pattern is hypothesized to correlate with RV enlargement rather than a conduction disturbance.…”

Atrial Septal Aneurysm and Intermittent Atrio -Ventricular Block: A Case Report and Literature Review

“…There are many evidences associating ASA and cardiac impulse conduction disorder (Bakalli et al, 2008;Bakalli et al, 2011). Several reports have shown possible association of right bundle branch block (RBBB) and ASA (Bakalli et al, 2008;Bakalli et al, 2011). But few publications have reported on the association of ASA and atrio-ventricular (AV) block (Odetunde et al, 2015).…”