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Cardiovasc Revasc Med. 2017 Mar;18(2):118-122. doi: 10.1016/j.carrev.2016.10.008. Epub 2016 Oct 29.

Clinically apparent long-term electric disturbances in the acute and very long-term of patent foramen ovale device-based closure.

Author information

1
Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy. Electronic address: jackyheart71@yahoo.it.
2
Department of Cardiology, Rovigo General Hospital, Rovigo, Italy and Section of Internal and Cardiopulmonary Medicine, Department of Medical Science, University of Ferrara, Ferrara, Italy.
3
Department of Cardiovascular Disease, Cittadella General Hospital, Padua, Italy.
4
Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy.
5
Interventional Electrophysiology Unit, Rovigo General Hospital, Rovigo, Italy.

Abstract

BACKGROUND/PURPOSE:

Incidence of electrical disturbances in patients submitted to transcatheter patent foramen ovale (PFO) closure has not been fully clarified in a large population. The aim of the study is to assess the incidence of atrial fibrillation, supraventricular tachi-arrhythmias, and atrio-ventricular block in the acute and very long-term follow-up.

METHODS/MATERIALS:

We reviewed the medical and instrumental data of 1000 consecutive patients (mean age 47.3±17.1years) prospectively enrolled in two centers over a 13-year period (February 1999 to February 2012) for right-to-left (R-to-L) shunt ICE-aided catheter-based closure using different devices.

RESULTS:

Successful transcatheter PFO closure was achieved in 99.8% of the patients. Implanted devices were: Amplatzer PFO Occluder in 463 patients (46.3%), Amplatzer ASD Cribriform Occluder in 420 patients (42.0%), Premere Occlusion System in 95 patients (9.5%), and Biostar Occluder in 22 patients (2.2%). Postprocedural electrical complications occurred in 5.9% of patients. The only independent predictors of electrophysiological complications were female gender (OR 2.3, 0.5-5.1 [95% CI], p<0.001) and device disk >30mm (OR 5.0, 1.2-7.2 [95% CI], p<0.001). On a mean follow-up of 12 .3±0.6years (minimum 4- maximum 17years), electrical complications occurred in 1.4% of patients including one only case of complete AVB and 5 cases of permanent AF. The only independent predictors were female gender (OR 2.3, 0.5-5.1 [95% CI], p<0.001) and device disk >30mm (OR 5.0, 1.2-7.2 [95% CI], p<0.001).

CONCLUSION:

Device-based closure of PFO using different devices, appeared very safe from an electrophysiological point of view with low incidence of electrical disturbances even in the very long-term follow-up.

KEYWORDS:

Anatomy; Echocardiography; Patent foramen ovale; Stroke

PMID:
27847261
DOI:
10.1016/j.carrev.2016.10.008
[Indexed for MEDLINE]

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