Atrial flutter/fibrillation in patients receiving transcatheter closure of atrial septal defect

Shuenn Nan Chiu, Mei Hwan Wu, Chia Ti Tsai, Ling Ping Lai, Jiunn Lee Lin, Ming Tai Lin, Chun Wei Lu, Jou Kou Wang

Research output: Contribution to journalArticle

Abstract

Background/purpose Atrial flutter/fibrillation (AFL/Af) is a common late complication in atrial septal defect (ASD) patients even after occluder implantation. We try to delineate the risk factors of persistent AFL/Af. Methods From 1998 to 2010, all patients older than 18 years of age who received ASD occluder implantation in our hospital were enrolled, and their records were retrospectively reviewed. In addition, renin–angiotensin system gene polymorphisms including angiotensinogen gene, A1166C polymorphism on the angiotensin II type I receptor gene, and insertion/deletion (I/D) patterns on the angiotensin-converting enzyme gene were checked using direct sequencing. Results A total of 517 patients (male/female 127/390) were enrolled. The mean age of patients receiving occluder deployment was 41.5 ± 14.5 years. Prior to occluder deployment, 3.9% of patients had persistent Af, 3.1% of patients had paroxysmal Af, and 0.8% had AFL. After a follow-up of 1894 patient-years, 3.5% had persistent Af and 1.9% of patients had paroxysmal Af. The greatest risk factors of AFL/Af genesis included age, occluder size, presence of multiple ASDs, and underlying thyroid or mitral valve disorder (p < 0.001, p < 0.001, p = 0.033, p = 0.016, and p = 0.012, respectively). Preoperative AFL/Af status is the most important factor in determining AFL/Af resolution and progression after an intervention. The renin–angiotensin system gene polymorphisms had no association with AFL/Af genesis, and progression or resolution after intervention. Conclusion AFL/Af is common after ASD occluder implantation, and predisposed by older age, larger and multiple ASDs, and underlying disorders. Preoperative atrial arrhythmia status is the most important predictor of AFL/Af progression or resolution. Renin–angiotensin system gene polymorphisms had no association with AFL/Af.

Original languageEnglish
Pages (from-to)522-528
Number of pages7
JournalJournal of the Formosan Medical Association
Volume116
Issue number7
DOIs
Publication statusPublished - Jul 1 2017
Externally publishedYes

Fingerprint

Atrial Flutter
Atrial Heart Septal Defects
Atrial Fibrillation
Septal Occluder Device
Genes
Angiotensin I
Angiotensinogen
Angiotensin Receptors
Insertional Mutagenesis
Gene Deletion
Peptidyl-Dipeptidase A
Mitral Valve
Cardiac Arrhythmias
Thyroid Gland

Keywords

  • atrial flutter/fibrillation
  • atrial septal defect
  • gene
  • renin–angiotensin

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Atrial flutter/fibrillation in patients receiving transcatheter closure of atrial septal defect. / Chiu, Shuenn Nan; Wu, Mei Hwan; Tsai, Chia Ti; Lai, Ling Ping; Lin, Jiunn Lee; Lin, Ming Tai; Lu, Chun Wei; Wang, Jou Kou.

In: Journal of the Formosan Medical Association, Vol. 116, No. 7, 01.07.2017, p. 522-528.

Research output: Contribution to journalArticle

Chiu, Shuenn Nan ; Wu, Mei Hwan ; Tsai, Chia Ti ; Lai, Ling Ping ; Lin, Jiunn Lee ; Lin, Ming Tai ; Lu, Chun Wei ; Wang, Jou Kou. / Atrial flutter/fibrillation in patients receiving transcatheter closure of atrial septal defect. In: Journal of the Formosan Medical Association. 2017 ; Vol. 116, No. 7. pp. 522-528.
@article{449d8536d7854564873458ec0d86533b,
title = "Atrial flutter/fibrillation in patients receiving transcatheter closure of atrial septal defect",
abstract = "Background/purpose Atrial flutter/fibrillation (AFL/Af) is a common late complication in atrial septal defect (ASD) patients even after occluder implantation. We try to delineate the risk factors of persistent AFL/Af. Methods From 1998 to 2010, all patients older than 18 years of age who received ASD occluder implantation in our hospital were enrolled, and their records were retrospectively reviewed. In addition, renin–angiotensin system gene polymorphisms including angiotensinogen gene, A1166C polymorphism on the angiotensin II type I receptor gene, and insertion/deletion (I/D) patterns on the angiotensin-converting enzyme gene were checked using direct sequencing. Results A total of 517 patients (male/female 127/390) were enrolled. The mean age of patients receiving occluder deployment was 41.5 ± 14.5 years. Prior to occluder deployment, 3.9{\%} of patients had persistent Af, 3.1{\%} of patients had paroxysmal Af, and 0.8{\%} had AFL. After a follow-up of 1894 patient-years, 3.5{\%} had persistent Af and 1.9{\%} of patients had paroxysmal Af. The greatest risk factors of AFL/Af genesis included age, occluder size, presence of multiple ASDs, and underlying thyroid or mitral valve disorder (p < 0.001, p < 0.001, p = 0.033, p = 0.016, and p = 0.012, respectively). Preoperative AFL/Af status is the most important factor in determining AFL/Af resolution and progression after an intervention. The renin–angiotensin system gene polymorphisms had no association with AFL/Af genesis, and progression or resolution after intervention. Conclusion AFL/Af is common after ASD occluder implantation, and predisposed by older age, larger and multiple ASDs, and underlying disorders. Preoperative atrial arrhythmia status is the most important predictor of AFL/Af progression or resolution. Renin–angiotensin system gene polymorphisms had no association with AFL/Af.",
keywords = "atrial flutter/fibrillation, atrial septal defect, gene, renin–angiotensin",
author = "Chiu, {Shuenn Nan} and Wu, {Mei Hwan} and Tsai, {Chia Ti} and Lai, {Ling Ping} and Lin, {Jiunn Lee} and Lin, {Ming Tai} and Lu, {Chun Wei} and Wang, {Jou Kou}",
year = "2017",
month = "7",
day = "1",
doi = "10.1016/j.jfma.2016.09.005",
language = "English",
volume = "116",
pages = "522--528",
journal = "Journal of the Formosan Medical Association",
issn = "0929-6646",
publisher = "Elsevier Science Publishers B.V.",
number = "7",

}

TY - JOUR

T1 - Atrial flutter/fibrillation in patients receiving transcatheter closure of atrial septal defect

AU - Chiu, Shuenn Nan

AU - Wu, Mei Hwan

AU - Tsai, Chia Ti

AU - Lai, Ling Ping

AU - Lin, Jiunn Lee

AU - Lin, Ming Tai

AU - Lu, Chun Wei

AU - Wang, Jou Kou

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Background/purpose Atrial flutter/fibrillation (AFL/Af) is a common late complication in atrial septal defect (ASD) patients even after occluder implantation. We try to delineate the risk factors of persistent AFL/Af. Methods From 1998 to 2010, all patients older than 18 years of age who received ASD occluder implantation in our hospital were enrolled, and their records were retrospectively reviewed. In addition, renin–angiotensin system gene polymorphisms including angiotensinogen gene, A1166C polymorphism on the angiotensin II type I receptor gene, and insertion/deletion (I/D) patterns on the angiotensin-converting enzyme gene were checked using direct sequencing. Results A total of 517 patients (male/female 127/390) were enrolled. The mean age of patients receiving occluder deployment was 41.5 ± 14.5 years. Prior to occluder deployment, 3.9% of patients had persistent Af, 3.1% of patients had paroxysmal Af, and 0.8% had AFL. After a follow-up of 1894 patient-years, 3.5% had persistent Af and 1.9% of patients had paroxysmal Af. The greatest risk factors of AFL/Af genesis included age, occluder size, presence of multiple ASDs, and underlying thyroid or mitral valve disorder (p < 0.001, p < 0.001, p = 0.033, p = 0.016, and p = 0.012, respectively). Preoperative AFL/Af status is the most important factor in determining AFL/Af resolution and progression after an intervention. The renin–angiotensin system gene polymorphisms had no association with AFL/Af genesis, and progression or resolution after intervention. Conclusion AFL/Af is common after ASD occluder implantation, and predisposed by older age, larger and multiple ASDs, and underlying disorders. Preoperative atrial arrhythmia status is the most important predictor of AFL/Af progression or resolution. Renin–angiotensin system gene polymorphisms had no association with AFL/Af.

AB - Background/purpose Atrial flutter/fibrillation (AFL/Af) is a common late complication in atrial septal defect (ASD) patients even after occluder implantation. We try to delineate the risk factors of persistent AFL/Af. Methods From 1998 to 2010, all patients older than 18 years of age who received ASD occluder implantation in our hospital were enrolled, and their records were retrospectively reviewed. In addition, renin–angiotensin system gene polymorphisms including angiotensinogen gene, A1166C polymorphism on the angiotensin II type I receptor gene, and insertion/deletion (I/D) patterns on the angiotensin-converting enzyme gene were checked using direct sequencing. Results A total of 517 patients (male/female 127/390) were enrolled. The mean age of patients receiving occluder deployment was 41.5 ± 14.5 years. Prior to occluder deployment, 3.9% of patients had persistent Af, 3.1% of patients had paroxysmal Af, and 0.8% had AFL. After a follow-up of 1894 patient-years, 3.5% had persistent Af and 1.9% of patients had paroxysmal Af. The greatest risk factors of AFL/Af genesis included age, occluder size, presence of multiple ASDs, and underlying thyroid or mitral valve disorder (p < 0.001, p < 0.001, p = 0.033, p = 0.016, and p = 0.012, respectively). Preoperative AFL/Af status is the most important factor in determining AFL/Af resolution and progression after an intervention. The renin–angiotensin system gene polymorphisms had no association with AFL/Af genesis, and progression or resolution after intervention. Conclusion AFL/Af is common after ASD occluder implantation, and predisposed by older age, larger and multiple ASDs, and underlying disorders. Preoperative atrial arrhythmia status is the most important predictor of AFL/Af progression or resolution. Renin–angiotensin system gene polymorphisms had no association with AFL/Af.

KW - atrial flutter/fibrillation

KW - atrial septal defect

KW - gene

KW - renin–angiotensin

UR - http://www.scopus.com/inward/record.url?scp=85005773750&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85005773750&partnerID=8YFLogxK

U2 - 10.1016/j.jfma.2016.09.005

DO - 10.1016/j.jfma.2016.09.005

M3 - Article

C2 - 27816405

AN - SCOPUS:85005773750

VL - 116

SP - 522

EP - 528

JO - Journal of the Formosan Medical Association

JF - Journal of the Formosan Medical Association

SN - 0929-6646

IS - 7

ER -