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P WAVE CHARACTERISTICS BEFORE AND AFTER TRANSCA THETER CLOSURE OF SECUNDUM ATRIAL SE PTAL DEFECT

Yip WCL1,2, Ho TF1, Chan KY2,  Quek SC1

1 National University of Singapore, Singapore

2 Gleneagles Medical Center, Singapore

 

Objective: P maximum (pm) and p dispersion (pd) have been used as predictors of atrial dysrhythmias in adults The aim of this study was to assess these parameters before and after transcatheter closure of atrial septal defects (ASD).

Methods: Twenty-three patients(9 males and 14 females; mean±SD age at procedure:14.2±16.3years)with isolated ASD who had undergone transcatheter device closure(20 Amplatzer septal occluders,3 Starflex occluders)and 22 age-and sex-matched controls were studied Resting 12-lead ECG was used to measure p waves from which pm and pd(difference between maximum and minimum p wave duration)were derived.

Results: Patients had significantly longer mean pm(10.8±10.6vs93.3±10.8msec,p<0.0001)and pd(39.7±11.7vs26.1±6.2msec, p<0.0001). Significant reduction of mean pm to 99.5±10.9 msec and mean pd to 31.1±8.7msec were observed within the first 7 days post-closure as compared to the pre-closure values Mean pm and pd remained closely similar with marginal decrease in pd over 3 years post-closure follow-up.

Conclusion: Prolonged atrial conduction time and inhomogeneity of atrial conduction in patients with ASD were favourably altered by transcatheter  closure of the defects.