Atrial Arrhythmia after Surgical Closure of Atrial Septal Defects in Adults

• Published in: The New England journal of medicine Vol. 340; no. 11; pp. 839 - 846
• Main Authors: Gatzoulis, Michael A, Freeman, Marc A, Siu, Samuel C, Webb, Gary D, Harris, Louise
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 18.03.1999
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Atrial Fibrillation - epidemiology; Atrial Fibrillation - etiology; Atrial Flutter - epidemiology; Atrial Flutter - etiology; Biological and medical sciences; Cardiac arrhythmia; Female; Follow-Up Studies; Health risk assessment; Heart Septal Defects, Atrial - surgery; Humans; Incidence; Male; Medical research; Medical sciences; Middle Aged; Multivariate Analysis; Postoperative Complications - epidemiology; Pulmonary Wedge Pressure; Risk Factors; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Treatment Outcome; Human; Postoperative; Arrhythmia; Atrial fibrillation; Cardiovascular disease; Intracardiac defect; Congenital disease; Surgical closure; Excitability disorder; Atrial flutter; Treatment; Malformation; Heart disease; Surgery; Risk factor; Atrial septal defect; Adult; Complication; Preoperative
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM199903183401103

Atrial flutter and atrial fibrillation are well-documented sequelae of atrial septal defects, associated with substantial morbidity and, occasionally, death. 1 – 3 The prevention of atrial flutter or fibrillation or the restoration of sinus rhythm in patients with these defects is therefore desirable. The surgical closure of atrial septal defects leads to improved functional status and reduces the risk of right-sided heart failure and progressive or severe pulmonary hypertension. 1 , 4 , 5 Atrial flutter or fibrillation, however, has often persisted at late follow-up (>25 years) in patients who have undergone surgical closure after childhood (reported incidence, 41 to 59 percent). 1 , 4 – 7 Evidence . . .