Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-29T14:22:22.015Z Has data issue: false hasContentIssue false
  • English
  • Français

Pacemaker and conduction disturbances in patients with atrial septal defect

Published online by Cambridge University Press:  05 June 2020

Diana H. R. Albæk Open the ORCID record for Diana H. R. Albæk [Opens in a new window] ,
Sebastian Udholm ,
Anne-Sif L. Ovesen ,
Zarmiga Karunanithi ,
Camilla Nyboe  and
Vibeke E. Hjortdal
Diana H. R. Albæk*
Affiliation:
Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark
Sebastian Udholm
Affiliation:
Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark
Anne-Sif L. Ovesen
Affiliation:
Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark
Zarmiga Karunanithi
Affiliation:
Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark
Camilla Nyboe
Affiliation:
Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark
Vibeke E. Hjortdal
Affiliation:
Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark
*
Author for correspondence: Diana Højrup Runegaard Albæk, MD, Department of Cardiothoracic Surgery, Aarhus University Hospital, Palle Juul-Jensens Blvd. 99, 8200 Aarhus, Denmark. Tel: +45 31425002; Fax: +45 78453079. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine the prevalence of pacemaker and conduction disturbances in patients with atrial septal defects.

Design:

All patients with an atrial septal defect born before 1994 were identified in the Danish National Patient Registry, and 297 patients were analysed for atrioventricular block, bradycardia, right bundle branch block, left anterior fascicular block, left posterior fascicular block, pacemaker, and mortality. Our results were compared with pre-existing data from a healthy background population. Further, outcomes were compared between patients with open atrial septal defects and atrial septal defects closed by surgery or transcatheter.

Results:

Most frequent findings were incomplete right bundle branch block (40.1%), left anterior fascicular block (3.7%), atrioventricular block (3.7%), and pacemaker (3.7%). Average age at pacemaker implantation was 32 years. Patients with defects closed surgically or by transcatheter had an increased prevalence of atrioventricular block (p < 0.01), incomplete right bundle branch block (p < 0.01), and left anterior fascicular block (p = 0.02) when compared to patients with unclosed atrial septal defects. At age above 25 years, there was a considerably higher prevalence of atrioventricular block (9.4% versus 0.1%) and complete right bundle branch block (1.9% versus 0.4%) when compared to the background cohorts.

Conclusions:

Patients with atrial septal defects have a considerably higher prevalence of conduction abnormalities when compared to the background population. Patients with surgically or transcatheter closed atrial septal defects demonstrated a higher demand for pacemaker and a higher prevalence of atrioventricular block, incomplete right bundle branch block, and left anterior fascicular block when compared to patients with unclosed atrial septal defects.

Keywords

CHDatrial septal defectatrioventricular blockincomplete right bundle branch blockcomplete right bundle branch blockpacemaker
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 7 , July 2020 , pp. 980 - 985
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Hoffman, JI, Kaplan, S.The incidence of congenital heart disease. J Am Coll Cardiol 2002; 39: 1890–1900.CrossRefGoogle ScholarPubMed
Mori, S, Nishii, T, Tretter, JT, Spicer, DE, Hirata, KI, Anderson, RH.Demonstration of living anatomy clarifies the morphology of interatrial communications. Heart 2018; 104: 2003–2009.CrossRefGoogle ScholarPubMed
Nyboe, C, Olsen, MS, Nielsen-Kudsk, JE, Hjortdal, VE.Atrial fibrillation and stroke in adult patients with atrial septal defect and the long-term effect of closure. Heart 2015; 101: 706–711.CrossRefGoogle ScholarPubMed
Karunanithi, Z, Nyboe, C, Hjortdal, VE.Long-term risk of atrial fibrillation and stroke in patients with atrial septal defect diagnosed in childhood. Am J Cardiol 2017; 119: 461–465.CrossRefGoogle ScholarPubMed
Nyboe, C, Olsen, MS, Nielsen-Kudsk, JE, Johnsen, SP, Hjortdal, VE.Risk of pneumonia in adults with closed versus unclosed atrial septal defect (from a nationwide cohort study). Am J Cardiol 2014; 114: 105–110.CrossRefGoogle Scholar
Nyboe, C, Karunanithi, Z, Nielsen-Kudsk, JE, Hjortdal, VE.Long-term mortality in patients with atrial septal defect: a nationwide cohort-study. Eur Heart J 2018; 39: 993–998.CrossRefGoogle ScholarPubMed
Udholm, S, Nyboe, C, Karunanithi, Z, et al.Lifelong burden of small unrepaired atrial septal defect: results from the Danish National Patient Registry. Int J Cardiol 2019; 283: 101–106.CrossRefGoogle ScholarPubMed
Ellesoe, SG, Johansen, MM, Bjerre, JV, Hjortdal, VE, Brunak, S, Larsen, LA.Familial atrial septal defect and sudden cardiac death: identification of a novel NKX2-5 mutation and a review of the literature. Congenit Heart Dis 2016; 11: 283–290.CrossRefGoogle Scholar
Pashmforoush, M, Lu, JT, Chen, H, et al.Nkx2-5 pathways and congenital heart disease; loss of ventricular myocyte lineage specification leads to progressive cardiomyopathy and complete heart block. Cell 2004; 117: 373–386.CrossRefGoogle ScholarPubMed
Geva, T, Martins, JD, Wald, RM.Atrial septal defects. Lancet 2014; 383: 1921–1932.CrossRefGoogle ScholarPubMed
Vitarelli, A, Mangieri, E, Gaudio, C, Tanzilli, G, Miraldi, F, Capotosto, L.Right atrial function by speckle tracking echocardiography in atrial septal defect: prediction of atrial fibrillation. Clin Cardiol 2018; 41: 1341–1347.CrossRefGoogle ScholarPubMed
Webb, G, Gatzoulis, MA.Atrial septal defects in the adult: recent progress and overview. Circulation 2006; 114: 1645–1653.CrossRefGoogle ScholarPubMed
Kadish, AH BA, Kennedy, HL, Knight, BP, Mason, JW, Schuger, CD, Tracy, CM.ACC/AHA clinical competence statement on electrocardiography and ambulatory electrocardiography: a report of the American College of Cardiology/American Heart Association/American College of Physicians – American Society of Internal Medicine Task Force on Clinical Competence (ACC/AHA Committee to Develop a Clinical Competence Statement on Electrocardiography and Ambulatory Electrocardiography). Circulation 2001; 104: 3169–3178.Google Scholar
Ove, B.Schaffalitzky de Muckadell, SH, Vilstrup, H. Medicinsk kompendium. Vol. 18. Nyt nordisk forlag Arnold Busck, København, 2013.Google Scholar
De Bacquer, D, De Backer, G, Kornitzer, M.Prevalences of ECG findings in large population based samples of men and women. Heart 2000; 84: 625–633.CrossRefGoogle ScholarPubMed
Niwa, K, Warita, N, Sunami, Y, Shimura, A, Tateno, S, Sugita, K.Prevalence of arrhythmias and conduction disturbances in large population-based samples of children. Cardiol Young 2004; 14: 68–74.CrossRefGoogle ScholarPubMed
Asakai, H, Weskamp, S, Eastaugh, L, d’Udekem, Y, Pflaumer, A.Atrioventricular block after ASD closure. Heart Asia 2016; 8: 26–31.CrossRefGoogle ScholarPubMed
Kirkfeldt, RE, Johansen, JB, Nohr, EA, Jorgensen, OD, Nielsen, JC.Complications after cardiac implantable electronic device implantations: an analysis of a complete, nationwide cohort in Denmark. Eur Heart J 2014; 35: 1186–1194.CrossRefGoogle ScholarPubMed
Bussink, BE, Holst, AG, Jespersen, L, Deckers, JW, Jensen, GB, Prescott, E. Right bundle branch block: prevalence, risk factors, and outcome in the generel population: results from the Copenhagen City Heart Study. Eur Heart J 2012; 34: 138–146.CrossRefGoogle Scholar
Cuypers, JA, Opic, P, Menting, ME, et al.The unnatural history of an atrial septal defect: longitudinal 35 year follow up after surgical closure at young age. Heart 2013; 99: 1346–1352.CrossRefGoogle ScholarPubMed