Atrial fibrillation screening on systematic ambulatory electrocardiogram monitoring after percutaneous patent foramen ovale closure: A prospective study.

BACKGROUND

Increased risk of new-onset atrial fibrillation (AF) after patent foramen ovale (PFO) closure was observed in randomized trials without however systematic AF screening. We aimed to evaluate the incidence of AF within 6-month following PFO closure with serial 24-hour ambulatory electrocardiogram (AECG) monitoring.

METHODS

All patients undergoing PFO closure were prospectively included in 2 centers. AF was defined as irregular rhythm without discernible P waves > 30 s on AECG at day 0, 1-month and 6-month follow-up. Primary endpoint was the incidence of AF within the study period. Secondary endpoints evaluated clinical outcomes within 6-month follow-up.

RESULTS

Between February 2018 and March 2019, 62 patients underwent PFO closure including 40 male (64.5%) with a mean age of 48 ± 9.5. Atrial septal aneurysm was observed in 37 patients (64.9%), 57 patients (91.9%) received an Amplatzer Occluder device (Abbott Vascular) and 5 (8.1%) an Occlutech device (Occlutech). After a mean follow-up of 7.7 ± 2.8 months, new-onset AF occurred in 3 patients (4.8%), all within the first month following PFO closure, including one per-procedural, all were asymptomatic and paroxysmal. Two patients with AF (3.2%) required chronic oral anticoagulant therapy. No adverse outcomes occurred at follow-up. No predictive factors of AF were highlighted. A total of 16 patients (25.8%) reported palpitations without AF on the AECGs.

CONCLUSION

In highly selected patients, incidence of AF, evaluated with 3 systematic 24-hour AECG within 6-month following PFO closure, was low (<5%). Always paroxysmal, AF occurred within the first month after the procedure and was not associated with adverse outcomes.

Informations de copyright

© 2021 The Author(s).

Déclaration de conflit d'intérêts

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper: [F. Leclercq received research grants from Edwards, Medtronic, Boehringer; consultant fees from Boehringer; and lecture fees from Astra Zeneca and Bayer. B. Lattuca received research grants from ACTION Study group, Biotronik, Boston Scientific, Daiichi-Sankyo, Fédération Française de Cardiologie and Institute of CardioMetabolism and Nutrition; consultant fees from Daiichi-Sankyo and Eli Lilly; and lecture fees from AstraZeneca and Novartis. G Cayla received research grants/consultant fees/lectures fees from Amgen, AstraZeneca, Bayer, Boehringer-Ingelheim, Boston, Biotronik, Bristol-Myers Squibb, Daiichi-Sankyo, Eli-Lilly, Europa, Fédération Française de Cardiologie, Fondation Cœur & Recherche, Medtronic, MSD, Pfizer, Sanofi-Aventis. M. Akodad received research grants from Fédération Française de Cardiologie, MUSE-Explore, Biotronik and Medtronic.].