Effect of history of atrial arrhythmias on the rate of recurrent stroke in patients after PFO closure
| Autor: | O Jiravsky, L Gajdusek, M Hudec, J Balusik, J Chovancik, P Kufova, R Miklik, L Sknouril, J Januska |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Europace. 25 |
| ISSN: | 1532-2092 1099-5129 |
| DOI: | 10.1093/europace/euad122.041 |
| Popis: | Funding Acknowledgements Type of funding sources: None. Introduction Although the importance of persistent foramen ovale (PFO) closure is well established, it is far from complete its role in patients with atrial arrhythmias. Patients with a history of atrial arrhythmias, especially younger and healthy persons with PFO after a stroke, are indicated for PFO closure. This is despite the uncertainty of whether atrial arrhythmia (it means silent atrial fibrillation) is the actual cause of the stroke. Objectives To describe prospective observations comparing cohort PFO closure patients with and without atrial arrhythmias. Method A retrospective analysis of the real world of a prospective registry of patients after PFO closure. This is a set of patients from one cardiac center over 19 years; each patient was followed up once a year for seven years. The recurrence of ischemic stroke was monitored. Results A total of 712, 378 females (53.1%) and 334 males, aged 50 (+/-12) years, were indicated for PFO closure mostly due to stroke (436 i.e. 61.4%) and systemic embolization (56 i.e. 7.9%). DM was present in 55 patients ( i.e. 7.7%), and arterial hypertension was also in 306 patients (i.e. 43%). See other demographic data in Table 1. A history of atrial arrhythmias ( salvage SVES or intrinsic atrial fibrillation) before PFO closure was described in 50 patients ( 7.1%). During the 7-year follow-up, recurrent stroke was detected in a total of 14 cases, 13 in the group without previous arrhythmic history (4.3%) and 1 with previous arrhythmic history (3.8%, p=0.912). A surprising finding was the statistically higher representation of women in the cohort with previous arrhythmic history (p=0.001), in the cohort of shorter (p=0.012) and thinner (p=0.022) women, and thus in the cohort with lower BSA (p=0.006). On the other hand, unsurprisingly, there was a statistically higher proportion of diabetics (p0.024) and patients with coronary artery disease (p=0.013) in the cohort with atrial arrhythmias in the pre-hospital period. Detailed results are in table 1. Conclusion There was no difference in the incidence of recurrent stroke between the cohorts of patients with and without a prior history of atrial arrhythmias in the seven-year follow-up after PFO closure. The cohort of patients with a previous history of atrial arrhythmias was, unsurprisingly, statistically larger in patients with diabetes and coronary artery disease. |
| Databáze: | OpenAIRE |
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