Download PDF
Thorac Cardiovasc Surg 2006; 54(4): 259-263
DOI: 10.1055/s-2006-923955
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Risk Factors for Atrial Fibrillation in Adult Patients in Long-Term Observation Following Surgical Closure of Atrial Septal Defect Type II

M. Piechowiak1 , M. Banach2 , J. Ruta1 , M. Barylski3 , J. Rysz4 , K. Bartczak2 , L. Markuszewski5 , J. Zasłonka2 , J. H. Goch1
  • 11st Department of Cardiology, Medical University, University Hospital No. 3, Lodz, Poland
  • 2Department of Cardiac Surgery, Medical University, University Hospital No. 3, Lodz, Poland
  • 3Department of Internal Diseases and Cardiological Rehabilitation, Medical University, University Hospital No. 5, Lodz, Poland
  • 42nd Department of Family Medicine, Medical University, University Hospital No. 2, Lodz, Poland
  • 5Department of Interventional Cardiology, Cardiodiabetology and Cardiac Rehabilitation, Medical University, University Hospital No. 2, Lodz, Poland
Further Information

Publication History

Received December 15, 2005

Publication Date:
02 June 2006 (online)

    Permissions and Reprints All articles of this category

Abstract

Background: The aim of the study was to find the factors predictive for paroxysmal atrial fibrillation (AF) following surgical correction of atrial septal defect type II (ASD t.II). Methods: 93 patients, who underwent isolated surgical closure of ASD t.II between 1990 and 2001 were included. Follow-up studies were performed 2 - 11 years after surgery. Patients were divided into two groups according to the presence of AF before and after surgery. Group AF (+) consisted of 29 and group AF (-) of 64 patients. All patients underwent echocardiography, electrocardiogram (ECG) at rest, and signal-averaged P-wave duration (PWD) in signal-averaged ECG. The following parameters were assessed in echocardiography: pulmonary artery systolic pressure, left and right atrial dimensions, right ventricular dimension, tricuspid and mitral regurgitation. Results: Paroxysmal AF was observed in 27 patients before surgery and in 29 after surgery. Analyzing all potential risk factors we proved that PWD may independently predict occurrence of postoperative AF. Conclusion: PWD may independently predict postoperative AF in long-term follow-up after surgical correction of ASD t.II.

Key words

Atrial septal defect type II - atrial fibrillation - P-wave duration - risk factors

References

  • 1 Anderson R H, Brown N A, Webb S. Development and structure of the atrial septum.  Heart. 2002;  88 104-110
    CrossrefPubMedSearch in Google Scholar
  • 2 Trojnarska O, Breborowicz P, Ochotny R, Cieslinski A. Permanent cardiac pacing in adult patients with congenital heart disease after cardiac surgery.  Arch Med Sci. 2005;  1 211-217
    PubMedSearch in Google Scholar
  • 3 McMahon C J, Feltes T F, Fraley J K. et al . Natural history of growth of secundum atrial septal defects and implications for transcatheter closure.  Heart. 2002;  87 256-259
    CrossrefPubMedSearch in Google Scholar
  • 4 Piechowiak M, Ruta J, Maciejewski M, Banach M, Zasłonka J, Goch J. Risk factors of supraventricular arrhythmias before and after surgical closure of atrial septal defect (ASD t.II) in adults.  Europace. 2005;  7 (Suppl 1) 219
    PubMedSearch in Google Scholar
  • 5 Gatzoulis M A, Freeman M A, Siu S C, Webb G D, Harris L. Atrial arrhythmia after surgical closure of atrial septal defects in adults.  N Engl J Med. 1999;  340 839-846
    CrossrefPubMedSearch in Google Scholar
  • 6 Gatzoulis M A, Redington A N, Somerville J, Shore D F. Should atrial septal defect in adults be closed?.  Ann Thorac Surg. 1996;  61 657-659
    CrossrefPubMedSearch in Google Scholar
  • 7 Ghosh S, Chatterjee S, Black E, Firmin R K. Surgical closure of atrial septal defects in adults: effect of age at operation on outcome.  Heart. 2002;  88 485-487
    CrossrefPubMedSearch in Google Scholar
  • 8 Majewska B, Różański J, Baranowski R, Rydlewska-Sadowska W. Supraventricular arrhythmias in adult patients with atrial septal defect t.II before and in long-term follow-up after surgery.  Pol Arch Med Wewn. 1999;  6 1077-1082
    PubMedSearch in Google Scholar
  • 9 Mullen M J, Diaz B F, Walker F, Sui S C, Benson L, McLaughlin P R. Accuracy and reliability of intracardiac echocardiography guided device closure of atrial septal defects.  J Am Coll Cardiol. 2002;  39 17
    PubMedSearch in Google Scholar
  • 10 Murphy J G, Gerssh B J, Mcgoon M D. Long-term outcome after surgical repair of isolated atrial septal defect. Follow-up at 27 to 32 years.  N Engl J Med. 1990;  323 1645-1650
    PubMedSearch in Google Scholar
  • 11 Oliver J M, Gallego P, Gonzalez A, Benito F, Mesa J M, Sobrino J A. Predisposing conditions for atrial fibrillation in atrial septal defect with and without operative closure.  Am J Cardiol. 2002;  89 39-43
    PubMedSearch in Google Scholar
  • 12 Shah D, Azhar M, Oakley C M, Cleland J GF, Nihoyannopoulos P. Natural history of secundum atrial septal defect in adults after medical or surgical treatment: a history prospective study.  B Heart J. 1994;  71 224-228
    PubMedSearch in Google Scholar
  • 13 Shibata Y, Abe T, Kuribayashi R. et al . Surgical treatment of isolated secundum atrial septal defect in patients more than 50 years old.  Ann Thorac Surg. 1996;  62 1096-1099
    CrossrefPubMedSearch in Google Scholar
  • 14 Banach M, Okoński P, Zasłonka J. Atrial fibrillation following cardiosurgical operations - current guidelines of pharmacotherapy and invasive treatment.  Pol Przegl Chirurg. 2005;  77 398-412
    PubMedSearch in Google Scholar
  • 15 Brandenburg Jr R O, Holmes D R, Brandenburg R O, McGoon D C. Clinical follow-up study of paroxysmal supraventricular tachyarrhythmias after operative repair of a secundum type atrial septal defect in adults.  Am J Cardiol. 1983;  51 273-276
    CrossrefPubMedSearch in Google Scholar
  • 16 Jemielity M, Dyszkiewicz W, Paluszkiewicz L, Perek B, Buczkowski P, Poniżyński A. Do patients over 40 years of age benefit from surgical closure of atrial septal defects?.  Heart. 2001;  85 300-303
    CrossrefPubMedSearch in Google Scholar
  • 17 Roos-Hesselink J W, Meijboom F J, van Domburg R. et al . Excellent survival and low incidence of arrhythmias, stroke and heart failure long-term after surgical ASD closure at young age.  Eur Heart J. 2003;  24 190-197
    PubMedSearch in Google Scholar
  • 18 Vignati G, Crupi G, Vanini V, Iorio F S, Borghi A, Giusti S. Surgical treatment of arrhythmias related to congenital heart diseases.  Ann Thorac Surg. 2003;  75 1194-1199
    CrossrefPubMedSearch in Google Scholar
  • 19 Morton J B, Sanders P, Vohra J K. et al . Effect of chronic right atrial stretch on atrial electrical remodeling in patients with atrial septal defect.  Circul. 2003;  107 1775-1782
    PubMedSearch in Google Scholar
  • 20 Konstantinides S, Geibel A, Olschewski M. et al . A comparison of surgical and medical therapy for atrial septal defect in adults.  N Engl J Med. 1995;  333 469-473
    CrossrefPubMedSearch in Google Scholar
  • 21 Steele P M, Fuster V, Cohen M. et al . Isolated atrial septal defect with pulmonary vascular obstructive disease - long-term follow-up and prediction of outcome after surgical correction.  Circul. 1987;  5 1037-1042
    PubMedSearch in Google Scholar
  • 22 Cecchi F, Montereggi A, Olivotto I. et al . Risk for atrial fibrillation in patients with hypertrophic cardiomyopathy assessed by signal-averaged P-wave duration.  Heart. 1997;  78 44-49
    PubMedSearch in Google Scholar
  • 23 Inamura N, Matsushita T, Fukunami M, Sano T, Takeuchi M, Kurotobi S. P-wave signal-averaged electrocardiography in patients undergoing the Fontan operation.  J Cardiol. 2002;  39 101-107
    PubMedSearch in Google Scholar
  • 24 Pierog M, Banasiak W, Telichowski A. et al . Significance of atrial signal-averaged electrocardiogram analysis in diagnosis of paroxysmal atrial fibrillation in patients with mitral valve prolapse.  Pol Arch Med Wewn. 1997;  97 232-238
    PubMedSearch in Google Scholar
  • 25 Rosiak M, Bolińska H, Ruta J. P-wave dispersion and P-wave duration on SAECG in predicting atrial fibrillation in patients with acute myocardial infarction.  Ann Noninvasive Electrocardiol. 2002;  7 363-368
    PubMedSearch in Google Scholar
  • 26 Stafford P J, Kolvekar S, Cooper J. et al . Signal-averaged P-wave compared with standard electrocardiography or echocardiography for prediction of atrial fibrillation after coronary bypass grafting.  Heart. 1997;  77 417-422
    PubMedSearch in Google Scholar
  • 27 Steinberg J S, Zelenkofske S, Wong S C, Gelernt M, Sciacca R, Menchavez E. Value of P-wave signal-averaged ECG for predicting atrial fibrillation after cardiac surgery.  Circul. 1993;  88 2618-2622
    PubMedSearch in Google Scholar
  • 28 Piechowiak M, Zasłonka J, Iwaszkiewicz-Zasłonka A, Walczak A, Maciejewski M, Banach M, Goch J H. Heart condition before and after surgical treatment of atrial septal defect type II in adults.  Pol Merkuriusz Lek. 2005;  18 671-675
    PubMedSearch in Google Scholar

MD Maciej Banach

Department of Cardiac Surgery, Medical University

Sterlinga St. 1/3

91-425 Lodz

Poland

Phone: + 48426331558

Fax: + 48 4 26 33 15 58

Email: maciej.banach@kardiolog.pl