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Incidence of atrial fibrillation after percutaneous closure of patent foramen ovale and small atrial septal defects in patients presenting with cryptogenic stroke

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Published in European Journal of Cardiovascular Prevention & Rehabilitation. 2010, vol. 5, no. 1, p. 4-9
Abstract OBJECTIVE: The occurrence of atrial fibrillation after percutaneous closure of a patent foramen ovale for cryptogenic stroke has been reported in a variable percentage of patients. However, its precise incidence and mechanism are presently unclear and remain to be elucidated. DESIGN: Prospective follow-up study. PATIENTS: Ninety-two patients undergoing a percutaneous patent foramen ovale closure procedure (closure group) for cryptogenic stroke were compared with a similar group of 51 patients, who were medically treated. METHODS: A systematic arrhythmia follow-up protocol to assess the incidence of AF was performed including a 7-day event-loop recording at day 1, after 6 and 12 months in patients of the closure group and compared with those of the medically treated group. RESULTS: The incidence of AF was similar in both study groups during a follow-up of 12 months, including 7.6% (95% CI: 3.1-15.0%) in the closure and 7.8% (95% CI: 2.18-18.9%) in the medically treated group (P=1.0). The presence of a large patent foramen ovale was the only significant risk factor for the occurrence of AF as demonstrated by a multivariate Cox regression analysis (95% CI, 1.275-20.018; P=0.021). CONCLUSIONS: Our findings indicate that patients with cryptogenic stroke and patent foramen ovale have a rather high incidence of AF during a follow-up of 12 months. Atrial fibrillation occurred with a similar frequency whether the patent foramen ovale/atrial septal defect was successfully percutaneously closed or was medically managed. The presence of a large patent foramen ovale was the only significant predictor of AF occurrence during follow-up.
Keywords AdolescentAdultAgedAtrial Fibrillation/*epidemiology/ultrasonographyBrain Ischemia/complicationsCardiac Surgical ProceduresElectrocardiographyFemaleFollow-Up StudiesForamen Ovale, Patent/diagnosis/pathology/*surgeryHeart Septal Defects, Atrial/diagnosis/pathology/*surgeryHumansIschemic Attack, Transient/complicationsMaleMiddle AgedPostoperative Complications/*epidemiology/ultrasonographyRetrospective StudiesRisk FactorsStroke/*complications/etiologyYoung Adult
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PMID: 20088986
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Research group Ultrasonographie et pathologies neurovasculaires (700)
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BONVINI, Robert et al. Incidence of atrial fibrillation after percutaneous closure of patent foramen ovale and small atrial septal defects in patients presenting with cryptogenic stroke. In: European Journal of Cardiovascular Prevention & Rehabilitation, 2010, vol. 5, n° 1, p. 4-9. https://archive-ouverte.unige.ch/unige:19696

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Deposited on : 2012-04-23

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