Incidence and influencing factors of right-to-left shunt in iatrogenic atrial septal defect after interventional therapy for atrial fibrillation
10.3969/j.issn.1009-0126.2024.01.002
- VernacularTitle:心房颤动介入术后医源性房间隔缺损右向左分流发生情况及其临床影响的研究
- Author:
Chunmeng GE
1
;
Bin NING
Author Information
1. 236000 阜阳市人民医院心血管内科 安徽医科大学
- Keywords:
atrial fibrillation;
heart septal defects,atrial;
radiofrequency ablation;
risk factors;
left atrial appendage closure;
iatrogenic atrial septal defect;
right-to-left shunt
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(1):5-8
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the incidence and influencing factors of right-to-left shunt(RLS)in patients with iatrogenic atrial septal defect(iASD)after atrial septal puncture during in-terventional therapy for atrial fibrillation and analyze the correlation with new onset migraine in order to provide a basis for the prevention and treatment of related clinical events.Methods A to-tal of 54 patients with atrial fibrillation who underwent interventional surgery[including radio-frequency catheter ablation(RFCA),left atrial appendage closure(LAAC),and'one-stop'sur-gery]in cardiologic department of our hospital from November 2022 to March 2023 were enrolled in this study.According to existence of RLS in iASD within 48 h after surgery,they were divided into RLS group(24 patients)and non-RLS group(30 patients).The general information and tran-sthoracic echocardiographic data were collected and analyzed for the occurrence and influencing factors of RLS.The incidence of new onset migraine within 3 months after operation was recorded in both groups.Results All these patients had left-to-right shunt of iASD,24 patients had RLS(44.44％),and the defect size was 5.12±0.80 mm.During the 3 months'follow-up period,there was no significant difference in the incidence of new onset migraine between the two groups(P＞0.05).Older age,increased proportion of persistent atrial fibrillation,and larger iASD size was seen in the RLS group than the non-RLS group(P＜0.05,P＜0.01).Multivariate logistic regres-sion analysis showed that iASD size was a risk factor for RLS(OR=2.245,95％CI:1.040-4.846,P=0.040).Conclusion RLS is common in iASD after interventional treatment of atrial fibrillation,which is not related to the early occurrence of new onset migraine in these patients.The size of iASD is a risk factor for RLS.At the same time,more attention should be paid to the influence of iASD on hemodynamics and clinical events.
