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New onset atrial fibrillation after patent foramen ovale closure
Author(s) -
Staubach Stephan,
Steinberg Daniel H.,
Zimmermann Wibke,
Wawra Nikolaus,
Wilson Neil,
Wunderlich Nina,
Sievert Horst
Publication year - 2009
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.22172
Subject(s) - medicine , atrial fibrillation , patent foramen ovale , cardiology , cardioversion , incidence (geometry) , population , stroke (engine) , migraine , mechanical engineering , physics , environmental health , optics , engineering
Objectives : In this study, we evaluated the incidence of new onset atrial fibrillation (symptomatic or detected by routine ECG) after patent foramen ovale (PFO‐) closure. Background : Although atrial fibrillation is known to occur in some patients following patent foramen ovale closure, the incidence and the risk associated with each device is not well known. Methods : We evaluated 1,349 consecutive patients who underwent PFO closure with an approved device and examined the incidence and risk factors associated with the development of atrial fibrillation. The patients had a mean age of 50 years and underwent PFO closure for cerebrovascular accident in 696 (51.6%), transient ischemic attack in 610 (45.2%), paradoxical embolism in 22 (1.6%), decompression sickness in 13 (0.9%), and other reasons including migraine headaches in 6 (0.4%) of cases. Results : Over a mean follow‐up period of 38.1 ± 28 months, 53 (3.9%) patients developed new onset atrial fibrillation, which is higher compared with an age‐matched population. Of these, 33 (62.3%) patients developed atrial fibrillation within 4 weeks and 8 (15%) within 6 months following PFO closure (totally 77% from 0 to 6 months). The event consisted of a single paroxysm lasting less than 48 hr in 23 patients, resolving either spontaneously or with cardioversion. 40 (75.5%) patients were symptomatic at the time of diagnosis. Thirty (56.6%) patients developed chronic atrial fibrillation. On multivariate analysis, advanced age and use of the STARFlex device predicted atrial fibrillation. Conclusions : The number of patients in whom atrial fibrillation was detected was relatively low. It is often a self‐limited complication of PFO closure that may occur more frequently in elderly patients and those treated with the STARFlex device. © 2009 Wiley‐Liss, Inc.