Immediate and short term effects of percutaneous atrial septal defect device closure on cardiac electrical remodeling in children

Roushdy, Alaa; Attia, Hebatalla; Nossir, Heba Kamel

doi:10.1016/j.ehj.2018.02.005

Cited by 7 publications

(4 citation statements)

References 18 publications

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“…They found that mean P wave dispersion decreased after closure and this decrease continued even months after. 36 Grignani et al had similar results in their study and saw that 25 children with atrial septal defect whose defects were closed by transcatheter method had a decrease in P wave dispersion after 2 months of closure (p < 0.001). 37 On the other hand, there are studies claiming that there is no change in mean P wave dispersion after closure or moreover showing an increase after closure.…”

Section: Discussionmentioning

confidence: 61%

P wave dispersion in assessment of dysrhythmia risk in patients with secundum type atrial septal defect and the effect of transcatheter or surgical closure

et al. 2019

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AbstractAtrial dysrhythmia is an important cause of mortality and morbidity in patients with atrial septal defect. Increased P wave duration can predict the risk of atrial dysrhythmia. The aim of this study is to evaluate the risk of atrial dysrhythmia by measuring P wave dispersion, and to observe the effect of surgical and transcatheter closure. Sixty-one patients and 30 controls were investigated. In patient group, before and after closure and in control group at the time of presentation, 12-lead electrocardiography records were evaluated. P wave duration and amplitude, P wave axis, PR interval, P wave dispersion, QRS axis, corrected QT interval, and QT dispersion were calculated. The measurements in patient and control groups, measurements before and after closure, and measurements of surgical and transcatheter group were compared. There were 27 patients in surgical group and 34 patients in transcatheter group. In patient group, signs of right heart volume overload were apparent but there was no significant difference in terms of P wave dispersion between two groups. We compared patient group in itself and found that while the use of medication, cardiothoracic index, ratio of right ventricular dilation, and paradoxical movement in interventricular septum were increased, mean age of closure was younger in surgical group. While P wave dispersion decreased in transcatheter group after closure, it increased in surgical group (p = 0.021). In conclusion, atrial septal defects may cause atrial repolarisation abnormalities and this effect persists even after surgical closure. Transcatheter closure in childhood may decrease dysrhythmia risk in long-term follow-up.

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Section: Discussionmentioning

confidence: 61%

P wave dispersion in assessment of dysrhythmia risk in patients with secundum type atrial septal defect and the effect of transcatheter or surgical closure

et al. 2019

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“…Ozylimaz et al [32] did not show any statistically significant change in P wave maximum duration and P wave dispersion at 24 h after percutaneous closure in a pediatric population. Conversely, Roushdy et al [15] describes a positive electrical remodeling, in terms of reduction of P wave and QTc dispersion, at 24 h from ASD closure with the Amplatzer device, and these changes were confirmed at 6 months. However, no data concerning the P wave dispersion were reported in this study.…”

Section: Discussionmentioning

confidence: 99%

“…A greater dispersion of the QTc is an important electrophysiological marker that is directly related to greater susceptibility to ventricular arrhythmias and, no less, to sudden cardiac death in cases of several comorbidities [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, decrease in P wave and QTc dispersion is supposed to assume a protective role in the development of atrial and/or ventricular arrhythmias [13][14][15][16][17]. Previous studies showed positive atrial and ventricular electrical remodeling after percutaneous ASD closure in terms of reduction of P wave and QTc dispersion, although the time-course of these changes may be partly hindered by the presence of the occluding device [14].…”

Section: Introductionmentioning

confidence: 99%

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Mid-Term Electrical Remodeling after Percutaneous Atrial Septal Defect Closure with GCO Device in a Pediatric Population

Fumanelli,

Garibaldi,

Castaldi

et al. 2023

JCM

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Background and aim: The GORE® CARDIOFORM (GCO) septal occluder is an atrial septal defect/patent foramen ovale closure device with theoretical advantages over other commercialized devices thanks to its softness and anatomical compliance. Our aim was to evaluate the short- and medium-term electrocardiographic changes after percutaneous ASD closure with GCO in a pediatric population. Methods: We enrolled 39 patients with isolated ASD submitted to trans-catheter closure from January 2020 to June 2021. ECG was performed before, at 24 h and 6 months after the procedure. P wave dispersion, QTc and QTc dispersion were calculated. ECG Holter was recorded at 6 months after implantation. Results: Patients’ age and body surface area (BSA) were 8.2 ± 4.2 years and 1.0 ± 0.3 m2 respectively. At the baseline, mean P wave dispersion was 40 ± 15 msec and decreased at 24 h (p < 0.002), without any further change at 6 months. At 24 h, PR conduction and QTc dispersion significantly improved (p = 0.018 and p < 0.02 respectively), while the absolute QTc value considerably improved after 6 months. During mid-term follow-up, QTc dispersion remained stable without a significant change in PR conduction. The baseline cardiac frequency was 88.6 ± 12.6 bpm, followed by a slight reduction at 24 h, with a further amelioration at 6 months after the procedure (87.3 ± 14.2, p = 0.9 and 81.0 ± 12.7, p = 0.009, respectively). After device deployment, two patients developed transient, self-limited junctional rhythm. One of them needed a short course of Flecainide for atrial ectopic tachycardia. No tachy/brady-arrhythmias were recorded at the 6-month follow-up. ASD closure resulted in a marked decrease in right heart volumes and diameters at 6 months after percutaneous closure. Conclusions: Percutaneous ASD closure with the GCO device results in significant, sudden improvement of intra-atrial, atrio-ventricular and intraventricular electrical homogeneity. This benefit persists unaltered over a medium-term follow-up. These electrical changes are associated with a documented positive right heart volumetric remodeling at mid-term follow-up.

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Diagnosing Atrial Septal Defect from Electrocardiogram with Deep Learning

et al. 2021

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Immediate and short term effects of percutaneous atrial septal defect device closure on cardiac electrical remodeling in children

Cited by 7 publications

References 18 publications

P wave dispersion in assessment of dysrhythmia risk in patients with secundum type atrial septal defect and the effect of transcatheter or surgical closure

P wave dispersion in assessment of dysrhythmia risk in patients with secundum type atrial septal defect and the effect of transcatheter or surgical closure

Mid-Term Electrical Remodeling after Percutaneous Atrial Septal Defect Closure with GCO Device in a Pediatric Population

Diagnosing Atrial Septal Defect from Electrocardiogram with Deep Learning

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