Atrial flutter/fibrillation in patients receiving transcatheter closure of atrial septal defect.

Autor:	Chiu SN; Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan., Wu MH; Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan., Tsai CT; Department of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan., Lai LP; Department of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan., Lin JL; Department of Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan., Lin MT; Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan., Lu CW; Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan., Wang JK; Department of Pediatrics, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan. Electronic address: jkww@ntuh.gov.tw.
Jazyk:	angličtina
Zdroj:	Journal of the Formosan Medical Association = Taiwan yi zhi [J Formos Med Assoc] 2017 Jul; Vol. 116 (7), pp. 522-528. Date of Electronic Publication: 2016 Nov 02.
DOI:	10.1016/j.jfma.2016.09.005
Abstrakt:	Background/purpose: Atrial flutter/fibrillation (AFL/Af) is a common late complication in atrial septal defect (ASD) patients even after occluder implantation. We try to delineate the risk factors of persistent AFL/Af. Methods: From 1998 to 2010, all patients older than 18 years of age who received ASD occluder implantation in our hospital were enrolled, and their records were retrospectively reviewed. In addition, renin-angiotensin system gene polymorphisms including angiotensinogen gene, A1166C polymorphism on the angiotensin II type I receptor gene, and insertion/deletion (I/D) patterns on the angiotensin-converting enzyme gene were checked using direct sequencing. Results: A total of 517 patients (male/female 127/390) were enrolled. The mean age of patients receiving occluder deployment was 41.5 ± 14.5 years. Prior to occluder deployment, 3.9% of patients had persistent Af, 3.1% of patients had paroxysmal Af, and 0.8% had AFL. After a follow-up of 1894 patient-years, 3.5% had persistent Af and 1.9% of patients had paroxysmal Af. The greatest risk factors of AFL/Af genesis included age, occluder size, presence of multiple ASDs, and underlying thyroid or mitral valve disorder (p < 0.001, p < 0.001, p = 0.033, p = 0.016, and p = 0.012, respectively). Preoperative AFL/Af status is the most important factor in determining AFL/Af resolution and progression after an intervention. The renin-angiotensin system gene polymorphisms had no association with AFL/Af genesis, and progression or resolution after intervention. Conclusion: AFL/Af is common after ASD occluder implantation, and predisposed by older age, larger and multiple ASDs, and underlying disorders. Preoperative atrial arrhythmia status is the most important predictor of AFL/Af progression or resolution. Renin-angiotensin system gene polymorphisms had no association with AFL/Af. (Copyright © 2016. Published by Elsevier B.V.)
Databáze:	MEDLINE
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