P-wave dispersion between transcatheter and surgical closure of secundum-type atrial septal defect in childhood

AbstractPatients with atrial septal defect have an increased risk for atrial fibrillation. Increased P-wave dispersion predicts the development of atrial fibrillation. The aim of this study was to determine difference in P dispersion between transcatheter closure with Amplatzer septal occluder and surgical closure in childhood. A total of 68 children (the mean age was 7.2 plus or minus 3.3 years; the mean secundum atrial septal defects diameter was 17.3 plus or minus 5.4 millimetres) were evaluated in this study. Transcatheter closure was attempted in 41 children with secundum atrial septal defects, and the defect in 27 patients was closed by surgical techniques. P maximum, P minimum and P dispersion were measured by the 12-lead surface electrocardiography. P maximum, P minimum and P dispersion were found to be similar in patients with pre- and post-procedure (98.0 plus or minus 19.3 versus 95.1 plus or minus 23.0 milliseconds; 68.0 plus or minus 20.8 versus 67.6 plus or minus 24.3 milliseconds, 29.9 plus or minus 11.0 versus 27.1 plus or minus 12.1 milliseconds, respectively). There was no statistical significance in the comparison of P dispersion between the two groups. But in the surgical group, P-wave dispersion was decreased more significantly compared with baseline values (p-value equal to 0.03). In conclusion, there is no P dispersion between transcatheter closure with Amplatzer septal occluder and surgical closure of secundum atrial septal defect.

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Device Size for Transcatheter Closure of Ovoid Interatrial Septal Defect

The Heart Surgery Forum ◽

10.1532/hsf98.20121131 ◽

2013 ◽

Vol 16 (4) ◽

pp. 193

Author(s):

Eun Hyun Cho ◽

Jinyoung Song ◽

Eun Young Choi ◽

Sang Yoon Lee

Keyword(s):

Atrial Septal Defect ◽

Septal Defect ◽

Transcatheter Closure ◽

Defect Group ◽

Amplatzer Septal Occluder ◽

Septal Defects ◽

Atrial Septal Defects ◽

The Mean ◽

Computed Tomography Image ◽

Device Size

Background: For successful transcatheter closure of an atrial septal defect with the Amplatzer septal occluder, the shape of the defect should be considered before selecting the device size. The purpose of this study was to evaluate the results of transcatheter closure of an ovoid atrial septal defect.Methods: Between January 2010 and February 2012, cardiac computer tomography examinations were performed in 78 patients who subsequently underwent transcatheter closure of an atrial septal defect. In this retrospective study, we reviewed these patients' medical records. We defined an ovoid atrial septal defect as a value of 0.75 for the ratio of the shortest diameter of the defect to the longest diameter, as measured in a computed tomography image. Transthoracic echocardiography examinations were made at 1 day and 6 months after the procedure.Results: Transcatheter closure of an atrial septal defect was successful in 26 patients in the ovoid-defect group and in 52 patients in the round-defect group. There were no serious complications in either group, and the rate of complete closure at 6 months was 92.3% in the ovoid-defect group and 93.1% in the round-defect group (P > .05). The mean (SD) difference between the device size and the defect's longest diameter, and the mean ratio of the device size to the longest diameter were significantly smaller in the ovoid-defect group (1.7 � 2.9 versus 3.8 � 2.5 and 1.1 � 0.1 versus 1.3 � 0.2, respectively).Conclusions: Transcatheter closure of an atrial septal defect is indicated even for an ovoid atrial septal defect. Ovoid atrial septal defects can be closed successfully with smaller sizes of the Amplatzer septal occluder than for round atrial septal defects.

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P wave dispersion in assessment of dysrhythmia risk in patients with secundum type atrial septal defect and the effect of transcatheter or surgical closure

Cardiology in the Young ◽

10.1017/s1047951119002828 ◽

2019 ◽

Vol 30 (2) ◽

pp. 263-270

Author(s):

Mürüvvet Cenk ◽

Figen Akalın ◽

Berna Ç. Şaylan ◽

Koray Ak

Keyword(s):

Patient Group ◽

Septal Defect ◽

Transcatheter Closure ◽

Wave Dispersion ◽

P Wave ◽

P Wave Dispersion ◽

Surgical Closure ◽

P Wave Duration ◽

Before And After ◽

Surgical Group

AbstractAtrial dysrhythmia is an important cause of mortality and morbidity in patients with atrial septal defect. Increased P wave duration can predict the risk of atrial dysrhythmia. The aim of this study is to evaluate the risk of atrial dysrhythmia by measuring P wave dispersion, and to observe the effect of surgical and transcatheter closure. Sixty-one patients and 30 controls were investigated. In patient group, before and after closure and in control group at the time of presentation, 12-lead electrocardiography records were evaluated. P wave duration and amplitude, P wave axis, PR interval, P wave dispersion, QRS axis, corrected QT interval, and QT dispersion were calculated. The measurements in patient and control groups, measurements before and after closure, and measurements of surgical and transcatheter group were compared. There were 27 patients in surgical group and 34 patients in transcatheter group. In patient group, signs of right heart volume overload were apparent but there was no significant difference in terms of P wave dispersion between two groups. We compared patient group in itself and found that while the use of medication, cardiothoracic index, ratio of right ventricular dilation, and paradoxical movement in interventricular septum were increased, mean age of closure was younger in surgical group. While P wave dispersion decreased in transcatheter group after closure, it increased in surgical group (p = 0.021). In conclusion, atrial septal defects may cause atrial repolarisation abnormalities and this effect persists even after surgical closure. Transcatheter closure in childhood may decrease dysrhythmia risk in long-term follow-up.

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Maximum P Wave Duration and P Wave Dispersion in Adult Patients with Secundum Atrial Septal Defect: The Impact of Surgical Repair

Annals of Noninvasive Electrocardiology ◽

10.1111/j.1542-474x.2004.92532.x ◽

2004 ◽

Vol 9 (2) ◽

pp. 136-141 ◽

Cited By ~ 25

Author(s):

Umit Guray ◽

Yesim Guray ◽

Burcu Mecit ◽

M. Birhan Yilmaz ◽

Hatice Sasmaz ◽

...

Keyword(s):

Atrial Septal Defect ◽

Septal Defect ◽

Surgical Repair ◽

Wave Dispersion ◽

P Wave ◽

Secundum Atrial Septal Defect ◽

P Wave Dispersion ◽

Wave Duration ◽

P Wave Duration ◽

The Impact

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Persistent electrical and morphological atrial abnormalities after early closure of atrial septal defect

Cardiology in the Young ◽

10.1017/s1047951104005037 ◽

2004 ◽

Vol 14 (5) ◽

pp. 481-487 ◽

Cited By ~ 2

Author(s):

Clifford L. Cua ◽

Elizabeth E. Sparks ◽

David P. Chan ◽

Curt J. Daniels

Keyword(s):

Atrial Septal Defect ◽

Septal Defect ◽

Pearson Correlation ◽

P Wave ◽

Surgical Closure ◽

Septal Defects ◽

Atrial Septal Defects ◽

Pr Interval ◽

Early Closure ◽

The Right

Atrial arrhythmias are associated with enlarged atrial chambers and an increased duration of the P wave. Repair of atrial defects within the oval fossa is expected to normalize atrial size. Few studies, however, have evaluated electrical and morphological atrial features after repair. Our study was performed to determine if atrial abnormalities exist after surgical closure of such atrial septal defects, and whether early closure improves outcome. We recruited patients who had undergone surgical closure of a defect within the oval fossa, so-called “secundum” atrial septal defects. Electrocardiograms, signal averaged electrocardiograms, and echocardiograms were performed. Two-tailed test and Pearson correlation was utilized for statistical analysis. The population consisted of 20 patients and 27 controls, with the mean age of the patient being 11.25 ± 5.10 years, their age at surgery 6.55 ± 5.10 years, and the time since surgery 4.70 ± 2.61 years. The size of the right (23.88 ± 6.35 ml/m2 versus 18.84 ± 4.43 ml/m2) and left (21.91 ± 12.47 ml/m2 versus 17.72 ± 4.83 ml/m2) atrium were significantly larger in the patients. The duration of the P wave (108 ± 16 ms versus 96 ± 8 ms) and the duration of the PR interval (155 ± 18 ms versus 138 ± 23 ms) were longer. No correlation existed between age or interval since surgery with atrial sizes or measurements of the signal averaged electrocardiogram. We conclude that, despite surgical repair, abnormalities exist in patients with an atrial septal defect. Early surgery does not appear to prevent the atrial abnormalities.

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