Annual Meeting of the Belgian Society of Cardiology edition:29th location:Brussels, Belgium date:28-01-2010
Aims: Atrial fibrillation and flutter remain an important cause of morbidity in adults with atrial septal defect (ASD). This study aimed to investigate predisposing conditions for atrial arrhythmias and the influence of pulmonary artery pressures on their occurrence in different age categories.
Methods and results: Patients with ASD type secundum, older than 18 years, were selected through the databases of three medical centres in Belgium. Preprocedural, periprocedural and follow-up data were extracted. Analyzed variables were entered into univariate and multivariate models to assess independent correlations with atrial arrhythmias before, early after and late after ASD repair. Patients were stratified according to age at repair into age quartiles.
A total of 296 patients was included. Age at repair and creatinine were independently correlated with atrial arrhythmia before repair (P=0.036 and P=0.041). Age at repair was an independent predictor of late atrial arrhythmia (P=0.014). Right ventricular systolic pressure (RVSP) 35 mmHg (P=0.040) and age (P=0.015) were independently correlated with the presence of late atrial arrhythmia. Patients repaired between the ages of 60 and 80 who developed late atrial arrhythmia had higher mean pulmonary artery pressure (mPAP) at diagnosis (P=0.023) and more frequently had RVSP 35 mmHg during follow-up (P=0.014).
Conclusion: Both age at repair and creatinine correlated with atrial arrhythmia before repair. Age at repair was the main predictor of late atrial arrhythmia. Older patients with late atrial arrhythmia present with higher mPAP at repair and higher RVSP during follow-up, suggesting elevated pulmonary pressures as a risk factor for late atrial arrhythmia