Predictive Factor for New-Onset Atrial Arrhythmia after Surgical Repair of Atrial Septal Defects. Follow-Up at 10 to 20 Years

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Background and Methods: Atrial arrhythmia could occur after surgical repair of atrial septal defects (ASD). The aim of this study was to identify predictive factors for atrial arrhythmia in this patient group. The study involved 62 patients who had undergone surgical ASD repair in our institution between 1990 and 1999. Results: The mean age at surgery was 27.5±25.8 years. After a mean follow-up period of 15.0±2.0 years, 8 patients (13%) had experienced new-onset atrial arrhythmia, and 4 of them had atrial fibrillation. Cerebral infarction caused by atrial fibrillation had occurred in a patient. Two of the 3 patients with macroreentrant atrial tachycardia underwent successful radiofrequency catheter ablation. New-onset atrial arrhythmia was more likely to have developed at 10 to 20 years follow-up in patients who were older than 30 years at the time of surgery than in those who were 30 or younger (OR: 10.2, 95%CI: 1.16 to 88.67, P=0.035). The prevalence of new-onset atrial arrhythmia was not different between male and female, or between ostium secundum type and the other types, or between patch closure and direct closure. Conclusions: The risk of atrial arrhythmia in patients with surgical repair of ASD is related to the age at the time of surgical repair.