Abstract 15048: Long-Term Device Dependent Risk of Atrial Fibrillation and Flutter After Percutaneous Atrial Septal Closure
Background: Atrial fibrillation(AF) after percutaneous closure of an atrial septal defect (ASD) or patent foramen ovale (PFO) remains a significant potential complication. Device technologies differ in size, shape, and inflammatory reaction; characteristics that may impact arrhythmia risk.
Methods: A total of 4,102 consecutive patients with no prior history of AF who underwent percutanous septal closure for a PFO or ASD (closure cohort) were studied. The closure cohort was analyzed by device type (Amplatzer [n=2,864], Cardioseal [n=233], Gore [n=1005]). Multivariable Cox regression was utilized to determine 1 year AF/atrial flutter incidence.
Results: Average length of follow-up per device was: Amplatzer: 3.3±2.6 years, Cardioseal: 8.5±1.6 years, and Gore: 0.6±0.7 years (p<0.0001). Those patients who received a Cardioseal device were older, had higher rates of hypertension, diabetes, CVA and TIA. The Figure shows the Kaplan Meier survival curve for the occurrence of 1 year AF or flutter. Adjusted 1 year outcomes were more favorable with Gore and Amplatzer compared with Cardioseal (Amplatzer vs. Cardioseal: OR=0.38, p=0.007, Gore vs. Cardioseal: OR=0.37, p=0.02).
Conclusion: Following percutaneous septal closure, long-term atrial arrhythmia and stroke risk is significantly associated with septal device type. The differential device-based effects over time highlight the need for long-term outcomes trials to fully define outcomes after septal closure.
- © 2013 by American Heart Association, Inc.