Lancelin B, Crépieux A, Diebold B, Abbou B, Goujon J, Apoil E, Pauly-Laubry C, Maurice P
Arch Mal Coeur Vaiss. 1977 Dec;70(12):1283-91.
In a series of 300 cases whose atrial septal defects were closed (268 with ostium secundum, 27 with ostium primum, and 5 cases with both), arrhythmias were found in 60%. These were usually slow supraventricular arrhythmias caused by substitution (51%), and less commonly rapid supraventricular arrhythmias (27%), extra-systoles (16%), disorders of atrio-ventricular conduction of second and third degree and disorders of the auricle (6%). Conduction disorders were significantly more common (p less than 0.001) after closure of ostium primum (37%) than after closure of an ostium secundum (4.5%). Arrhythmias are most common during the first week (56%), and are usually of the slow type, and during the three succeeding weeks are markedly less frequent (31%) with a higher proportion (p less than 0.001) of the rapid type. No one anatomical type of ASD was complicated with arrhythmia more than the others. The slow type of arrhythmias occurred in the high ASDs, and the fast type especially amongst elderly patients. Longterm follow-up showed arrhythmias in 28% of patients with an ostium secundum defect. The factors influencing arrhythmias were age, cardiac enlargement, and the mean pulmonary arterial pressure. Arrhythmias were just as common in cases with a small shunt.
在300例房间隔缺损已闭合的病例中（继发孔型268例，原发孔型27例，两种类型均有的5例），60%发现有心律失常。这些心律失常通常是由替代引起的缓慢室上性心律失常（51%），较少见的是快速室上性心律失常（27%）、早搏（16%）、二度和三度房室传导障碍以及心房疾病（6%）。原发孔闭合后传导障碍明显更常见（p小于0.001）（37%），高于继发孔闭合后（4.5%）。心律失常在第一周最常见（56%），且通常为缓慢型，在随后的三周明显较少见（31%），快速型比例更高（p小于0.001）。没有一种解剖类型的房间隔缺损比其他类型更易并发心律失常。缓慢型心律失常发生在高位房间隔缺损患者中，快速型尤其在老年患者中多见。长期随访显示继发孔缺损患者中有28%出现心律失常。影响心律失常的因素有年龄、心脏扩大和平均肺动脉压。小分流病例中的心律失常同样常见。
