[Permanent rhythm and conduction disorders in patients surgically treated for atrial septal defect].

Abstract

Atrial septal defect (ASD) represents a congenital heart disease with good prognosis, however, atrial arrhythmias are well-documented complications. A retrospective study was performed to assess the prevalence, types and risk factors of arrhythmias in patients with ASD after surgical correction. 920 patients were analyzed retrospectively; cases with complex congenital heart disease or another systemic alteration conditioning atrial rhythm disturbances were excluded. 460 patients with ASD corrected by surgery were followed at least for six months after the procedure. 29.3% of patients were male and 70.7% female. Direct closure was performed in 63%, pericardial patch was installed in 27%. 29 patients (6.3%) had conduction and rhythm disturbances before surgery, the most common arrhythmias were atrial flutter (34.5%), first degree A-V block (31%) and low right atrial rhythm (27.6%). Six months after atrial defect closure, 65 patients (14.13%) had arrhythmias, 44.6% atrial flutter, 20% ectopic atrial rhythm, 10.8% sick sinus syndrome. The risk of atrial arrhythmias was related to age at surgical repair, pulmonary hypertension and atrial arrhythmias before surgery.