Albæk Diana H R, Udholm Sebastian, Ovesen Anne-Sif L, Karunanithi Zarmiga, Nyboe Camilla, Hjortdal Vibeke E
Department of Cardiothoracic Surgery, Aarhus University Hospital, Aarhus, Denmark.
Cardiol Young. 2020 Jul;30(7):980-985. doi: 10.1017/S1047951120001365. Epub 2020 Jun 5.
To determine the prevalence of pacemaker and conduction disturbances in patients with atrial septal defects.
All patients with an atrial septal defect born before 1994 were identified in the Danish National Patient Registry, and 297 patients were analysed for atrioventricular block, bradycardia, right bundle branch block, left anterior fascicular block, left posterior fascicular block, pacemaker, and mortality. Our results were compared with pre-existing data from a healthy background population. Further, outcomes were compared between patients with open atrial septal defects and atrial septal defects closed by surgery or transcatheter.
Most frequent findings were incomplete right bundle branch block (40.1%), left anterior fascicular block (3.7%), atrioventricular block (3.7%), and pacemaker (3.7%). Average age at pacemaker implantation was 32 years. Patients with defects closed surgically or by transcatheter had an increased prevalence of atrioventricular block (p < 0.01), incomplete right bundle branch block (p < 0.01), and left anterior fascicular block (p = 0.02) when compared to patients with unclosed atrial septal defects. At age above 25 years, there was a considerably higher prevalence of atrioventricular block (9.4% versus 0.1%) and complete right bundle branch block (1.9% versus 0.4%) when compared to the background cohorts.
Patients with atrial septal defects have a considerably higher prevalence of conduction abnormalities when compared to the background population. Patients with surgically or transcatheter closed atrial septal defects demonstrated a higher demand for pacemaker and a higher prevalence of atrioventricular block, incomplete right bundle branch block, and left anterior fascicular block when compared to patients with unclosed atrial septal defects.
确定房间隔缺损患者起搏器及传导障碍的患病率。
在丹麦国家患者登记处识别出所有1994年以前出生的房间隔缺损患者，对297例患者进行了房室传导阻滞、心动过缓、右束支传导阻滞、左前分支传导阻滞、左后分支传导阻滞、起搏器及死亡率分析。将我们的结果与来自健康背景人群的现有数据进行比较。此外，还比较了开放性房间隔缺损患者与经手术或经导管闭合房间隔缺损患者的结局。
最常见的发现是不完全性右束支传导阻滞（40.1%）、左前分支传导阻滞（3.7%）、房室传导阻滞（3.7%）和起搏器（3.7%）。起搏器植入的平均年龄为32岁。与未闭合房间隔缺损的患者相比，经手术或经导管闭合缺损的患者房室传导阻滞（p<0.01）、不完全性右束支传导阻滞（p<0.01）和左前分支传导阻滞（p=0.02）的患病率更高。与背景队列相比，25岁以上患者的房室传导阻滞（9.4%对0.1%）和完全性右束支传导阻滞（1.9%对0.4%）患病率显著更高。
与背景人群相比，房间隔缺损患者传导异常的患病率显著更高。与未闭合房间隔缺损的患者相比，经手术或经导管闭合房间隔缺损的患者对起搏器的需求更高，房室传导阻滞、不完全性右束支传导阻滞和左前分支传导阻滞的患病率也更高。
