Arrhythmic Risk and Treatment after Transcatheter Atrial Septal Defect Closure.
Silvia DeaconuAlexandru DeaconuGabriela MarascuMihaela Octavia StanculescuDragos CozmaEliza Elena CintezăRadu VatasescuPublished in: Diagnostics (Basel, Switzerland) (2023)
Atrial septal defect (ASD) represents the most common congenital heart defect identified in adulthood. Atrial and ventricular geometric remodeling due to intracardiac shunt increase the risk of arrhythmias, especially atrial fibrillation (AF). Clinical, echocardiography, electrocardiogram, and device-related predictors may be used to assess the risk of atrial arrhythmias after ASD closure. The underlying mechanisms in these patients are complex and at least in part independent of the structural remodeling secondary to hemodynamic overload. Device closure of the ASD itself and its timing impact future arrhythmia risk, as well as posing a challenge for when transseptal puncture is required. Sudden cardiac death (SCD) risk is higher than in the general population and an implantable cardioverter-defibrillator (ICD) may be indicated in selected cases.
Keyphrases
- atrial fibrillation
- catheter ablation
- left atrial
- autism spectrum disorder
- left atrial appendage
- attention deficit hyperactivity disorder
- oral anticoagulants
- heart failure
- left ventricular
- direct oral anticoagulants
- end stage renal disease
- intellectual disability
- ejection fraction
- depressive symptoms
- newly diagnosed
- mitral valve
- chronic kidney disease
- acute coronary syndrome
- pulmonary artery
- working memory
- early life
- combination therapy
- patient reported