Early ECG abnormalities associated with transcatheter closure of atrial septal defects using the Amplatzer® septal occluder

• Published in: Journal of interventional cardiac electrophysiology Vol. 4; no. 3; pp. 469 - 474
• Main Authors: HILL, Sharon L, BERUL, Charles I, PATEL, Hitendra T, RHODES, Jonathan, SUPRAN, Stacey E, CAO, Qi-Ling, HIJAZI, Ziyad M
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.10.2000; Springer Nature B.V
• Subjects: Adolescent; Analysis of Variance; Arrhythmias, Cardiac - diagnosis; Arrhythmias, Cardiac - etiology; Biological and medical sciences; Cardiac Catheterization - adverse effects; Cardiac Catheterization - instrumentation; Cardiac Catheterization - methods; Chi-Square Distribution; Child; Child, Preschool; Diseases of the cardiovascular system; Echocardiography, Transesophageal; Electrocardiography, Ambulatory; Female; Heart Septal Defects, Atrial - diagnosis; Heart Septal Defects, Atrial - therapy; Humans; Infant; Linear Models; Male; Medical sciences; Multivariate Analysis; Postoperative Complications - diagnosis; Prospective Studies; Prosthesis Implantation - adverse effects; Prosthesis Implantation - methods; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Sensitivity and Specificity; Human; Arrhythmia; Persistent fetal circulation; Instrumentation therapy; Cardiovascular disease; Intracardiac defect; Instrumental obliteration; Congenital disease; Electrodiagnosis; Malformation; Heart disease; Atrial septal defect; Electrocardiography; Complication; Ostium secundum; Technical equipment; Monitoring
• ISSN: 1383-875X; 1572-8595
• DOI: 10.1023/A:1009852312907

Conduction abnormalities and arrhythmias may occur in patients following secundum atrial septal defect (ASD) closure using the Amplatzer septal occluder (ASO). Therefore, the aim of this study was to prospectively perform ambulatory ECG monitoring to assess the electrocardiographic effects of transcatheter closure (TCC) of ASD using the ASO device. From 5/97 to 3/99, 41 patients with secundum ASD, underwent TCC using the ASO device at a median age of 9.2[emsp4 ]y. (0.5-87[emsp4 ]y.) and median weight of 34[emsp4 ]kg (5. 6-88[emsp4 ]kg.). Ambulatory Holter monitoring was performed pre- and immediately post TCC. Holter analysis included heart rate (HR), ECG intervals, supraventricular ectopy (SVE), ventricular ectopy (VE), and AV block. No change in baseline rhythm was noted in 37 patients (90%). Changes in AV conduction occurred in 3 patients (7%), including intermittent second degree AV block type II, and complete AV dissociation post closure. SVE was noted in 26 patients (63%) post closure, ranging from 5-2207 supraventricular premature beats (SVPB), including 9 patients (23%) with non-sustained supraventricular tachycardia (SVT), 3 of whom had short runs of SVT prior to closure. A significant increase in post-closure number of SVPB per hour (p=0.047) was noted. No significant difference was noted in PR interval, ventricular premature beats per hour, or QRS duration. Based on ambulatory ECG analysis, TCC of ASD with the ASO device is associated with an acute increase in SVE and a small risk of AV conduction abnormalities, including complete heart block. Long term follow-up studies will be necessary to determine late arrhythmia prevalence and relative frequency compared with standard surgical ASD repair.