Brandenburg R O, Holmes D R, Brandenburg R O, McGoon D C
Am J Cardiol. 1983 Jan 15;51(2):273-6. doi: 10.1016/s0002-9149(83)80048-4.
Adults with isolated secundum atrial septal defect (ASD) may present with paroxysmal atrial tachyarrhythmias. The clinical course of these rhythmic disturbances after correction of the ASD is unknown. Of 188 patients aged 44 years old or older with isolated ASD, 27 (14%) (mean age 52.7 years, range 44 to 71) had documented paroxysmal atrial tachyarrhythmias preoperatively: 16 had paroxysmal atrial fibrillation, 2 had atrial flutter, and 9 had supraventricular tachycardia. Among these 3 groups, there were no differences in age, sex, New York Heart Association class, duration of preoperative symptoms, mean right atrial and pulmonary arterial pressures, shunt size, atrial size, or follow-up period. After operative repair, follow-up data were available in all patients for a mean of 12 years (range 1.5 to 25). Of the 16 patients with preoperative paroxysmal atrial fibrillation, 14 (88%) continued to have increasingly frequent paroxysmal atrial fibrillation, culminating in sustained atrial fibrillation. In 1 of the 2 patients with paroxysmal atrial flutter, sustained atrial fibrillation developed. Of the 9 patients with preoperative paroxysmal supraventricular tachycardia, 5 had no further episodes of this arrhythmia postoperatively.
孤立性继发孔房间隔缺损（ASD）的成年患者可能会出现阵发性房性快速性心律失常。ASD矫正后这些节律紊乱的临床病程尚不清楚。在188例44岁及以上的孤立性ASD患者中，27例（14%）（平均年龄52.7岁，范围44至71岁）术前记录有阵发性房性快速性心律失常：16例为阵发性心房颤动，2例为心房扑动，9例为室上性心动过速。在这三组中，年龄、性别、纽约心脏协会分级、术前症状持续时间、平均右心房和肺动脉压力、分流大小、心房大小或随访时间均无差异。手术修复后，所有患者均有平均12年（范围1.5至25年）的随访数据。在16例术前阵发性心房颤动患者中，14例（88%）持续出现阵发性心房颤动且发作频率增加，最终发展为持续性心房颤动。2例阵发性心房扑动患者中有1例发展为持续性心房颤动。9例术前阵发性室上性心动过速患者中，5例术后未再出现这种心律失常发作。
