Identification of Risk Factors for Arrhythmia Post Transcatheter Closure of Perimembranous Ventricular Septal Defect.

OBJECTIVE

Arrhythmias are frequently observed after transcatheter closure of perimembranous ventricular septal defect (pmVSD), especially in the early postprocedure period. Independent risk factors associated with postclosure arrhythmias are still elusive. The current study aimed to identify such risk factors via regression analysis with a long-term follow-up.

METHODS

A group of 553 patients from June 2003 to December 2010 who received symmetric Amplatzer-type pmVSD occluders for pmVSD in our center were followed for 2-8 years. The complications during the follow-up period were classified as early (within 1 year), continuous (persisted >1 year), or late (recurrent or onset after 1 year). We first evaluated the potential risk factors (age, procedure time, size of the defect, size of the occluder, diameter of the defect, distance of lesion to aortic rim, distance of lesion to tricuspid rim, presence of aneurysm, orifice size on aneurysm, arrhythmia before procedure, procedure time) by comparing complicated and uncomplicated cases using univariate analysis, then logistic analysis for independent risk factors.

RESULTS

We identified 90 cases of early, 59 cases of continuous, and 13 cases of late complications. The size of the occluder was identified as an independent risk factor for early, continuous, and late arrhythmias. Preexisting arrhythmias were found to be risk factors for early and late arrhythmias, while the distance between the defect and the tricuspid rim was identified as a risk factor for continuous arrhythmias.

CONCLUSION

The size of the occluder, preexisting arrhythmias, and the distance between the defect and the tricuspid rim were found to be risk factors for arrhythmias after transcatheter closure of pmVSD. Selection of properly sized occluders might be crucial to reduce postclosure complications.