Incidence of atrial fibrillation and its related factors in patients over 40 years old with secondary atrial septal defect before and after interventional closure

Tao ZHU; Xiang XU; Haiyun HUANG; Chen WAN; Feng LIU; Xinfeng JIANG; Wenting WANG; Huakang LI; Qing YAO; Yanli GUO; Zhiyuan SONG

doi:10.16016/j.2097-0927.202206151

您当前的位置：

首页 >

文章列表页 >

Incidence of atrial fibrillation and its related factors in patients over 40 years old with secondary atrial septal defect before and after interventional closure

Clinical Medicine | 更新时间：2026-01-09

- Incidence of atrial fibrillation and its related factors in patients over 40 years old with secondary atrial septal defect before and after interventional closure
- Journal of Army Medical University Vol. 44, Issue 21, Pages: 2211-2216(2022)
- 作者机构：
  
  1.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：心血管内科
  2.400038 重庆，陆军军医大学(第三军医大学)第一附属医院：超声科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.2097-0927.202206151
  CLC： R181.32;R541.105;R541.75
- Received：23 June 2022，
  
  Revised：2022-08-22，
  
  Published：15 November 2022
- 稿件说明：
移动端阅览
Tao ZHU, Xiang XU, Haiyun HUANG, et al. Incidence of atrial fibrillation and its related factors in patients over 40 years old with secondary atrial septal defect before and after interventional closure[J]. Journal of Army Medical University, 2022, 44(21): 2211-2216.
DOI：

Tao ZHU, Xiang XU, Haiyun HUANG, et al. Incidence of atrial fibrillation and its related factors in patients over 40 years old with secondary atrial septal defect before and after interventional closure[J]. Journal of Army Medical University, 2022, 44(21): 2211-2216. DOI： 10.16016/j.2097-0927.202206151.

摘要

目的

探讨房间隔缺损(atrial septal defect

ASD)患者介入封堵术前后心房颤动(atrial fibrillation

AF)的发生率，并分析其相关危险因素。

方法

选择2014年8月至2021年6月在本院住院并接受介入封堵术的40岁以上继发孔ASD患者为研究对象，通过医院病历资料库收集患者的相关资料，进行回顾性分析。根据介入封堵术前是否有AF分为ASD伴AF组和ASD窦性心律组；另根据术后随访期间有无新发AF分为新发AF组和窦性心律组。比较ASD伴AF组、ASD封堵术后新发AF组与对应窦性心律组间的相关资料。

结果

共纳入40岁以上ASD患者280例，其中男性75例、女性205例，年龄40~83(54.51±10.02)岁。ASD介入封堵术前AF发生率为16

.07%(45/280)，封堵术前呈窦性心律的235例；患者随访(42.40±23.98)个月，期间新发AF 15例(6.38%)。与ASD窦性心律组比较，ASD伴AF组患者年龄更大(

＜0.001)、NYHA心功能Ⅱ级以上比例更多(

=0.004)、左右心房内径明显增加(

＜0.001)，右心室压力明显增高(

＜0.001)；介入封堵术后新发AF组与窦性心律组比较，同样显示年龄(

＜0.001)、左心房内径(

=0.008)、右心房内径(

=0.003)及右心室内径(

=0.042)更大，左心室射血分数(LVEF)更低(

=0.004)。Logistic回归分析结果显示年龄、左心房内径增大、NYHA心功能分级≥Ⅱ级、右室压增高是ASD患者合并房颤危险因素，其中年龄是ASD患者介入封堵术后新发AF主要危险因素。

结论

40岁以上继发孔ASD患者介入封堵术前后AF发生率均较高，年龄大、心房内径增大及NYHA心功能分级较高、RVP增高可能是导致AF发生的危险因素，其中年龄是ASD患者介入封堵术后新发AF的主要危险因素。

Abstract

Objective

To assess the incidence of atrial fibrillation (AF) in patients with atrial septal defect (ASD)before and after interventional closure

and analyze the related risk factors.

Methods

A retrospective study was carried out in the ASD patients over 40 years old undergoing interventional closure in our hospital from August 2014 to June 2021. According the presence of AF or not before interventional closure

they were divided into ASD plus AF group and ASD plus sinus rhythm group. Based on the occurrence of new-onset AF or not after interventional closure

they were also assigned into new-onset AF group and sinus rhythm group. The related factors were analyzed by comparing those in the ASD plus AF group

new-onset AF group and the sinus rhythm groups.

Results

A total of 280 patients were recruited in this study

including 75 males and 205 females

at a mean age of 40~83(54.51±10.02) years. The incidence of AF in ASD patients before interventional closure was 16.07% (45/280). Of the 235 patients who were in sinus rhythm before interventional closure

15 (6.38%) patients developed new-onset AF during the follow-up of 42.40±23.98 months. In comparison to the patients who did not have AF

the patients who h

ad AF before interventional closure were significantly older (

0.001)

and with NYHA functional class Ⅱ or worse (

=0.004)

dilated both left and right atriums (

0.001) and higher right ventricular pressure (

0.001). Compared to the patients with sinus rhythm after interventional closure

those with new-onset AF were older (

0.001)

and with dilated left atrium (

=0.008)

right atrium (

=0.003) and right ventricle (

=0.042)

but a lower left ventricular ejection fraction (LVEF

=0.004). Logistic regression analysis showed that older age

dilated left atriums

NYHA functional class ≥Ⅱ and elevated right ventricular pressure were risk factors of AF

and age was the main risk factors of new-onset AF in ASD patients after interventional closure.

Conclusion

The incidence of AF is quite high in ASD patients over 40 years old no matter before or after interventional occlusion. Older age

dilated atriums

worse NYHA functional class and higher right ventricular pressure may be the risk factors for the occurrence of AF

and among them

age is the main risk factor of new-onset AF.

关键词

Keywords

references

BOUCHARDY J, THERRIEN J, PILOTE L, et al . Atrial arrhythmias in adults with congenital heart disease[J ] . Circulation, 2009, 120(17): 1679-1686. DOI: 10.1161/circulationaha.109.866319.

ALNASSER S, LEE D, AUSTIN P C, et al . Long term outcomes among adults post transcatheter atrial septal defect closure: systematic review and meta-an alysis[J ] . Int J Cardiol, 2018, 270: 126-132. DOI: 10.1016/j.ijcard.2018.06.076.

TAKAYA Y, AKAGI T, KIJIMA Y, et al . Long-term outcome after transcatheter closure of atrial septal defect in older patients: impact of age at procedure[J ] . JACC Cardiovasc Interv, 2015, 8(4): 600-606. DOI: 10.1016/j.jcin.2015.02.002.

王健, 刘美英, 廖清池. 房间隔缺损合并心房颤动的介入治疗进展[J]. 心血管病学进展, 2019, 40(7): 1028-1031. DOI: 10.16806/j.cnki.issn.1004-3934.2019.07.016.

WANG J, LIU M Y, LIAO Q C. Interventional therapy of atrial septal defect with atrial fibrillation[J]. Adv Cardiovasc Dis, 2019, 40(7): 1028-1031. DOI: 10.16806/j.cnki.issn.1004-3934.2019.07.016.

潘子磊, 杨荣, 孔祥清, 等. 房间隔缺损并发的心房颤动的治疗探讨[J]. 南京医科大学学报(自然科学版), 2015, 35(5): 674-677. DOI: 10.7655/NYDXBNS20150515.

PAN Z L, YANG R, KONG X Q, et al . The treatment of atrial fibrillation with atrial septal defect[J ] . J Nanjing Med Univ Nat Sci, 2015, 35(5): 674-677. DOI: 10.7655/NYDXBNS20150515.

EVERTZ R, REINDERS M, HOUCK C, et al . Atrial fibrillation in patients with an atrial septal defect in a single centre cohort during a long clinical follow-up: its association with closure and outcome of therapy[J ] . Open Heart, 2020 , 7(2): e001298. DOI: 10.1136/openhrt-2020-001298.

OSTER M, BHATT A B, ZARAGOZA-MACIAS E, et al . Interventional therapy versus medical therapy for secundum atrial septal defect: a systematic review (part 2) for the 2018 AHA/ACC guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines[J ] . Circulation, 2019, 139(14): e814-e830. DOI: 10.1161/CIR.0000000000000605.

宋治远, 何国祥, 舒茂琴, 等. Amplatzer封堵器介入治疗房间隔缺损及动脉导管未闭的疗效评价[J]. 第三军医大学学报, 2004, 26(7): 637-639. DOI: 10.3321/j.issn:1000-5404.2004.07.024.

SONG Z Y, HE G X, SHU M Q, et al . Transcatheter closure of atrial septal defect and patent ductus arteriosus with Amplatzer occluder[J ] . J Third Mil Med Univ, 2004, 26(7): 637-639. DOI: 10.3321/j.issn:1000-5404.2004.07.024.

KONSTANTINIDES S, GEIBEL A, KASPER W, et al . The natural course of atrial septal defect in adults: a still unsettled issue[J ] . Klin Wochenschr, 1991, 69(12): 506-510. DOI: 10.1007/BF01649286.

MARGULESCU A D, MONT L. Persistent atrial fibrillation vs paroxysmal atrial fibrillation: differences in management[J ] . Expert Rev Cardiovasc Ther, 2017, 15(8): 601-618. DOI: 10.1080/14779072.2017.1355237.

VILLABLANCA P A, BRISTON D A, RODÉS-CABAU J, et al . Treatment options for the closure of secundum atrial septal defects: a systematic review and meta-analysis[J ] . Int J Cardiol, 2017, 241: 149-155. DOI: 10.1016/j.ijcard.2017.03.073.

NAKAGAWA K, AKAGI T, NAGASE S, et al . Efficacy of catheter ablation for paroxysmal atrial fibrillation in patients with atrial septal defect: a comparison with transcatheter closure alone[J ] . Europace, 2019, 21(11): 1663-1669. DOI: 10.1093/europace/euz207.

CHEN L, BAI Y, WANG F Y, et al . Transcatheter closure of atrial septal defects improves cardiac remodeling and function of adult patients with permanent atrial fibrillation[J ] . Chin Med J (Engl), 2015, 128(6): 780-783. DOI: 10.4103/0366-6999.152617.

ZULKIFLY H, LIP G Y H, LANE D A. Epidemiology of atrial fibrillation[J]. Int J Clin Pract, 2018, 72(3): e13070. DOI: 10.1111/ijcp.13070.

HOUCK C A, LANTERS E A H, HEIDA A, et al . Distribution of conduction disorders in patients with congenital heart disease and right atri al volume overload[J ] . JACC Clin Electrophysiol, 2020, 6(5): 537-548. DOI: 10.1016/j.jacep.2019.12.009.

NYBOE C, OLSEN M S, NIELSEN-KUDSK J E, et al . Atrial fibrillation and stroke in adult patients with atrial septal defect and the long-term effect of closure[J ] . Heart, 2015, 101(9): 706-711. DOI:10.1136/heartjnl-2014-306552.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Analysis of disease burden of atrial fibrillation and atrial flutter globally and in China and Japan from 1990 to 2021 and future trend prediction

Predictive value of peripheral blood piR-hsa-2700592 for prognosis of atrial fibrillation patients

Predictive value of peripheral blood SNORD55 for prognosis of atrial fibrillation patients

Clinical analysis of ultrasound-guided minimally invasive transcatheter closure for atrial septal defect: report of 52 patients

Correlation of rs2200733 polymorphism with atrial fibrillation, pulmonary vein size and recurrence after isolation

Related Author

FANG Lanxi

LIU Guanlin

YANG Yuhang

QI Zhi

DENG Qi

MENG Qiong

YANG Lei

WU Na

Related Institution

School of Public Health， Kunming Medical University， Kunming， Yunnan

First Affiliated Hospital of Kunming Medical University•First Clinical School

School of Public Health， Key Laboratory of Environmental Pollution Monitoring and Disease Control of Ministry of Education， Guizhou Medical University

Department of Epidemiology， Faculty of Military Preventive Medicine， Army Medical University （Third Military Medical University）

Department of Cardiology， First Affiliated Hospital， Army Medical University （Third Military Medical University）

⁰