Effect of Percutaneous Closure of Patent Foramen Ovale on Post-Procedural Arrhythmias

Atrial arrhythmias after percutaneous patent foramen ovale (PFO) closure, including atrial fibrillation (AF), has been consistently reported in different series suggesting a causal link between mechanical closure of PFO and the new onset of post-procedural arrhythmias (1,2,3). We have systematically assessed the effect of percutaneous PFO closure upon the development of post-procedural arrhythmias in 221 consecutive patients (144 women; mean age 48 ± 13 years) undergoing percutaneous PFO closure. At clinical evaluation, no patient had symptoms indicative or suggestive of arrhythmias. Indications for closure were the presence of significant (grade >1) basal or Valsalva-induced right-to-left atrial shunt (RLS) at contrast transthoracic echocardiography (TTE) associated with cryptogenic stroke (n = 75), repeated transient ischemic attacks (n = 108), severe migraine (≥4 attacks/monthly resistant to triple pharmacologic therapy including topiramate) with presence of multiple bilateral cerebral ischemic lesions at magnetic resonance imaging (n = 30), decompression illness (n = 4), platypnea-orthodeoxia syndrome (n = 2), and documented peripheral embolism (n = 2). All patients underwent 24-/48-h Holter monitoring or external loop recorder electrocardiography (ECG) recording 1 to 3 months before PFO closure and between 3 and 6 months after the procedure. All ECG recordings were manually reviewed. Supraventricular (SV) arrhythmias were categorized as sporadic ectopic beats (≥5% o...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - Category: Cardiology Source Type: research