TY  - JOUR
T1  - Arrhythmias developing after Transcatheter Atrial Septal Defect closure: Single-center follow-up results
TT  - Transkateter Atriyal Septal Defekt kapatma sonrası gelişen aritmiler: Tek merkez izlem sonuçları
AU  - Karaca, Serra
AU  - Nişli, Kemal
PY  - 2025
DA  - July
Y2  - 2024
DO  - 10.26650/jchild.2025.1592466
JF  - Çocuk Dergisi
PB  - Istanbul University
WT  - DergiPark
SN  - 1308-8491
SP  - 39
EP  - 43
VL  - 25
IS  - 1
LA  - en
AB  - Objective: Atrial Septal Defect (ASD), one of the most common congenital heart diseases, is usually asymptomatic in childhood, but is associated with long-term consequences such as arrhythmia, stroke, heart failure and pulmonary hypertension. In our study, we aimed to present our experiences in our center and provide information about the arrhythmias we encountered after transcatheter ASD closure, possible risk factors and their course.Methods:  In our study, the files of patients who underwent transcatheter ASD closure in our clinic between 2010 and 2020 were retrospectively scanned. It is a cross-sectional descriptive study. A total of 216 patients were included in our study (131 girls 60.6%, 85 boys 39.4%).. Since our study aimed to detect arrhythmias that developed after ASD closure, even though the follow-up period was long the data especially in the f irst 6 months after the procedure were evaluated. These evaluated data are: ECG findings, complaints expressed by the patients, if any, and 24-hour rhythm Holter results deemed necessary accordingly.Results: 216 patients (131 girls 60.6%, 85 boys 39.4%) whose data could be accessed in their files were included in our study. The mean age of the patients was 79±48.5 months (min 30 months, max:17 years ). The average ASD size of the patients was 14.27±3.85 mm (min: 9 mm, max:26 mm) and the mean device size was 16.8±3.7 mm (min: 10mm, max: 28 mm). All the patients were at sinus rhythm prior to procedure. Arrhythmia was detected in 13 of the 216 patients included in the study after the closure procedure. The arrhythmia rate after closure was 6%. Of the 13 patients with arrhythmia, supraventricular premature beat (SVE) was detected in 6, ventricular premature beat (VES) in 2, supraventricular tachycardia (SVT) in 2 patients, 1st degree AV block in 1 patient, 2nd degree AV block in 1 patient and 3rd degree AV block in 1 patient.Conclusions: Arrhythmias that develop after transcatheter treatment are not common and are usually temporary. The best option is to evaluate each patient individually and decide on closure at the most appropriate age possible.
KW  - ASD
KW  - arrhythmia
KW  - transcatheter closure
N2  - Amaç: En sık görülen konjenital kalp hastalıklarından biri olan Atriyal Septal Defekt (ASD), çocukluk çağında genellikle asemptomatiktir ancak aritmi, inme, kalp yetersizliği ve pulmoner hipertansiyon gibi uzun vadeli sonuçlarla ilişkilidir. Çalışmamızda merkezimizdeki deneyimlerimizi sunarak  transkateter ASD kapatma sonrası karşılaştığımız aritmiler, olası risk faktörleri ve seyri hakkında bilgi vermeyi amaçladık.Metod: Çalışmamız 2010-2020 yılları arasında kliniğimizde transkateter ASD kapatma işlemi uygulanan hastaların dosyalarının geriye dönük olarak taranarak değerlendirildiği kesitsel tanımlayıcı bir çalışmadır. Çalışmamıza toplam 216 hasta dahil edildi (131 kız %60,6, 85 erkek %39,4). ASD kapatılması sonrası gelişen aritmileri tespit etmek amaçlandığı için hastaların takip süresi daha uzun olmasına rağmen özellikle işlem sonrası ilk 6 aya ait veriler değerlendirildi. Değerlendirilen bu veriler: EKG bulguları, varsa hastaların ifade ettiği şikayetler ve buna göre gerekli görülen 24 saatlik ritim Holter sonuçları.Sonuçlar: Çalışmamıza dosyalarında verilerine ulaşılabilen 216 hasta (131 kız %60,6, 85 erkek %39,4) dahil edildi. Hastaların yaş ortalaması 79±48,5 ay (en az 30 ay, en fazla 17 yıl) idi. Hastaların ortalama ASD boyutu 14,27±3,85 mm (min: 9 mm, maks:26 mm), ortalama cihaz boyutu ise 16,8±3,7 mm (min: 10 mm, maks: 28 mm) idi. İşlem öncesi hastaların tamamı sinüs ritmindeydi. Çalışmaya dahil edilen 216 hastanın 13'ünde kapatma işlemi sonrasında aritmi tespit edildi. Kapatma sonrası aritmi oranı %6 idi. Aritmisi olan 13 hastanın 6'sında supraventriküler erken atım (SVE), 2'sinde ventriküler erken atım (VES), 2 hastada supraventriküler taşikardi (SVT), 1 hastada 1. derece AV blok, 1 hastada 2. derece AV blok ve 1 hastada 3. derece AV blok tespit edildi.Sonuç: Transkateter tedavi sonrasında gelişen aritmiler yaygın değildir ve genellikle geçicidir. En iyi seçenek, her hastayı ayrı ayrı değerlendirip mümkün olan en uygun yaşta kapatmaya karar vermektir.
CR  - Craig, R.J.; Selzer, A. Natural History and Prognosis of Atrial Septal Defect. Circulation 1968, 37, 805–815. google scholar
CR  - Siddiqui WT, Usman T, Atiq M, Amanullah MM. Transcatheter versus surgical closure of the atrial septum defect: a debate from a developing country. J Cardiovasc Thorac Res. 2014;6(4):205-210. google scholar
CR  - Ooi YK, Kelleman M, Ehrlich A et al. Transcatheter Versus surgical closure of atrial septal defects in children: a value comparison. JACC Cardiovasc Intv. 2016;9(1):79-86. google scholar
CR  - Murphy, J.G.; Gersh, B.J.; McGoon, M.D.; Mair, D.D.; Porter, C.J.; Ilstrup, D.M.; McGoon, D.C.; Puga, F.J.; Kirklin, J.W.; Danielson, G.K. Long-Term Outcome after Surgical Repair of Isolated Atrial Septal Defect. N. Engl. J. Med. 1990, 323, 1645–1650. google scholar
CR  - Silversides C, Haberer K Siu S, Webb G, Benson L, McLaughlin P. Predictors of atrial arrhythmias after device closure of secundumtype atrial septal defects in adults. Am J Cardiol 2008;101:683–7. google scholar
CR  - Williams MR, Perry JC. Arrhythmias and conduction disorders associated with atrial septal defects. J Thorac Dis. 2018;10(Suppl 24):2940–2944. google scholar
CR  - Suda K, Raboisson MJ, Piette E et al. Reversible atrioventricular block associated with the closure of atrial septal defects using the Am platzer device. J Am Coll Cardiol. 2004;43(9):1677– 1682. google scholar
CR  - Chessa M, Carminati M, Butera G et al. Early and late complications associated with transcatheter occlusion of the secundum atrial septal defect. J Am Coll Cardiol. 2002;39(6):1061–1065 google scholar
CR  - Hill SL, Berul CI, Patel HT, Rhodes J, Supran SE, Cao QL, et al. Early ECG abnormalities associated with transcatheter closure of the atrial septal defect using Amplatzer septal occluder. J Interv Card Electrophysiol 2000; 4: 469–474. google scholar
CR  - Komar M, Przewłocki T, Olszowska M, Sobień B, Stępniewski J, Podolec J, Mleczko S, Tomkiewicz-Pająk L, Zmudka K, Podolec P. Conduction abnormality and arrhythmia after transcatheter closure of atrial septal defect. Circ J. 2014;78(10):2415-21. Epub 2014 Aug 22. PMID: 25253507. google scholar
CR  - Szkutnik M, Lenarczyk A, Kusa J, Białkowski J. Symptomatic tachy-and bradyarrhythmias after transcatheter closure of interatrial communications with Amplatzer devices. Cardiol J 2008; 15: 510–516. google scholar
CR  - Wilson NJ, Smith J, Prommete B, O’Donnell C, Gentles TL, Ruygrok PN. Transcatheter closure of secundum atrial septal defects with the Amplatzer septal occluder in adults and children: Follow-up closure rates, degree of mitral regurgitation and evolution of arrhythmias. Heart Lung Circ 2008; 17: 318–324. google scholar
CR  - Mazzanti A, Kanthan A, Monteforte N, Memmi M, Bloise R, Novelli V et al. Novel insight into the natural history of short QT syndrome. J Am Coll Cardiol 2014; 63: 1300–1308. google scholar
CR  - Komar M, Przewlocki T, Olszowska M, Sobien B, Podolec P. The benefit of atrial septal defect closure in elderly patients. Clin Interv Aging 2014; 9: 1101–1107. google scholar
CR  - Komar M, Przewłocki T, Olszowska M, Sobień B, Tomkiewicz Pająk L, Podolec P. Is it worth closing the atrial septal defect in patients with an insignificant shunt? Postepy Kardiol Interwencyjnej 2014; 10: 78–83. google scholar
CR  - Cuypers JA, Opic P, Menting ME, Utens EM, Witsenburg M, Helbing WA et al. The unnatural history of an atrial septal defect: longitudinal 35-year follow-up after surgical closure at young age. Heart 2013;99:1346–52. google scholar
CR  - Brochu MC, Baril JF, Dore A et al. Improvement in exercise capacity in asymptomatic and mildly symptomatic adults after atrial septal defect percutaneous closure. Circulation 2002; 106: 1821-6. google scholar
CR  - Roos-Hesselink JW, Meijboom FJ, Spitaels SE, et al. Excellent survival and low incidence of arrhythmias, stroke, and heart failure long-term after surgical ASD closure at a young age. A prospective follow-up study of 21–33 years. Eur Heart J 2003; 24: 190-7. google scholar
CR  - 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: 469-73 google scholar
CR  - Horvath KA, Burke RP, Collins JJ, Cohn LH. Surgical treatment of adult atrial septal defect: early and long-term results. J Am Coll Cardiol 1992; 20: 1156-9. google scholar
CR  - Yüce M, Ozer O, Cakici M et al. Closure of the secundum atrial septal defects by the Amplatzer occluder device. Turk Kardiyol Dern Ars 2011; 39: 35-40 google scholar
CR  - X. Li, E. Wissner, M. Kamioka, H. Makimoto, P. Rausch, A. Metzner, et al., Safety and feasibility of transseptal puncture for atrial fibrillation ablation in patients with atrial septal defect closure devices, Heart Rhythm. 11 (2014) 330–335. google scholar
UR  - https://doi.org/10.26650/jchild.2025.1592466
L1  - https://dergipark.org.tr/en/download/article-file/4399048
ER  -