Paç Feyza Ayşenur, Balli Sevket, Topaloğlu Serkan, Ece Ibrahim, Oflaz Mehmet Burhan
Department of Pediatric Cardiology, Türkiye Yüksek İhtisas Education and Research Hospital, Ankara, Turkey.
Anadolu Kardiyol Derg. 2012 May;12(3):249-54. doi: 10.5152/akd.2012.069. Epub 2012 Mar 2.
Amplatzer septal occluder (ASO) is the most widely used device for closure of atrial septal defect (ASD). Figulla septal occluder (FSO) is a similar device to ASO with some structural innovations. The aim of study is to assess the maximum P-wave duration (Pmax) and dispersion (Pd) in patients who underwent ASD closure with both devices, to determine the effects of structural innovations on atrial electrical inhomogeneity.
The study is a retrospective cohort analysis. Between December 2005 and March 2010, 121 patients underwent percutaneous closure of secundum ASD were included in this study. FSO was used in 79 patients, ASO in 42 patients. Pmax and Pd were measured on the surface electrocardiography before and soon after procedure. For comparison of P-wave parameters initially and after procedure paired t-test was used. Correlation analysis was performed using Pearson correlation test.
Pmax and Pd were significantly increased immediate after procedure (p<0.001). In FSO and ASO group pre/postprocedural Pd were 38.3 ± 2.7/ 44.1 ± 2.7 msec and 37.5 ± 2.5/ 50.1 ± 2.2 msec respectively. ASO group had a greater postprocedural Pmax and Pd (p<0.001). Left and right atrial disc diameter and device size were the strongest correlates of Pd (r=0.52, p<0.001; r=0.58, p<0.001; r=0.35, p=0.001, respectively). Moderate correlation was found between pre-intervention Pd and age (p=0.008).
Pmax and Pd were significantly increased soon after atrial septal defect closure procedure in both devices. Pd is significantly lower in patients closed with FSO device. Difference may be due to the distinctive texture of devices. There was no significant difference in terms of clinically apparent arrhythmia after closure with both device types.
Amplatzer 房间隔封堵器（ASO）是目前应用最广泛的房间隔缺损（ASD）封堵器械。菲古拉房间隔封堵器（FSO）是一种与 ASO 类似但有一些结构创新的器械。本研究旨在评估使用这两种器械进行 ASD 封堵的患者的最大 P 波时限（Pmax）和离散度（Pd），以确定结构创新对心房电不均一性的影响。
本研究为回顾性队列分析。2005 年 12 月至 2010 年 3 月期间，121 例行继发孔型 ASD 经皮封堵术的患者纳入本研究。79 例患者使用 FSO，42 例患者使用 ASO。在术前及术后即刻在体表心电图上测量 Pmax 和 Pd。对于 P 波参数术前及术后的比较采用配对 t 检验。使用 Pearson 相关检验进行相关性分析。
术后即刻 Pmax 和 Pd 显著增加（p<0.001）。FSO 组和 ASO 组术前/术后 Pd 分别为 38.3±2.7/44.1±2.7 毫秒和 37.5±2.5/50.1±2.2 毫秒。ASO 组术后 Pmax 和 Pd 更大（p<0.001）。左、右心房盘直径和器械尺寸与 Pd 的相关性最强（r=0.52，p<0.001；r=0.58，p<0.001；r=0.35，p=0.001）。干预前 Pd 与年龄之间存在中度相关性（p=0.008）。
两种器械在房间隔缺损封堵术后即刻 Pmax 和 Pd 均显著增加。使用 FSO 器械封堵的患者 Pd 显著更低（差异可能归因于器械独特的质地）。两种器械封堵后在临床明显心律失常方面无显著差异。
