Short-term electrocardiographic atrial remodelling after asd closure with the gco device in a pediatric population

Abstract Funding Acknowledgements Type of funding sources: None. Background and Aim The GORE® CARDIOFORM septal occluder (GCO) is an atrial septal defect/patent foramen ovale (ASD/PFO) closure device with theoretical advantages over other commercialized devices thanks to its softness and anatomical...

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Published in:Europace (London, England) England), 2022-05, Vol.24 (Supplement_1)
Main Authors: Fumanelli, J, Garibaldi, S, Castaldi, B, Di Candia, A, Cuman, M, Pizzuto, A, Sirico, D, Mirizzi, G, Piacenti, M, Cantinotti, M, Assanta, N, Di Salvo, G, Santoro, G
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container_title Europace (London, England)
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creator Fumanelli, J
Garibaldi, S
Castaldi, B
Di Candia, A
Cuman, M
Pizzuto, A
Sirico, D
Mirizzi, G
Piacenti, M
Cantinotti, M
Assanta, N
Di Salvo, G
Santoro, G
description Abstract Funding Acknowledgements Type of funding sources: None. Background and Aim The GORE® CARDIOFORM septal occluder (GCO) is an atrial septal defect/patent foramen ovale (ASD/PFO) closure device with theoretical advantages over other commercialized devices thanks to its softness and anatomical compliance. Our aim was to evaluate the short and medium-term electrocardiographic changes after percutaneous ASD closure with GCO in a pediatric population. Methods We enrolled 39 patients with isolated ASD submitted to trans-catheter closure with GCO from January 2020 to June 2021. EKG was performed before (T0), at 24 hours (T1) and 6 months (T2) after ASD transcatheter closure. P wave dispersion was calculated as the difference between maximum and minimum P- wave duration, PR interval as the interval between beginning of the P wave and beginning of the QRS complex and QT dispersion as the difference between maximun and minimun of QTc intervals. At 6-months from device implantation, the patients were submitted to ambulatory EKG Holter recording. Results Patients’ age and BSA were 8.2±4.2 years (IQR 4.2-8.3, median 7.0) and 1.0±0.3 m2 (IQR 0.7-1.7, median 0.9), respectively. The strectched ASD diameter was 16.3±4.5 mm (median 16), resulting in QP/QS of 1.7±0.6 (median 1.5). At the baseline mean P wave dispersion was 40±15 msec and decreased to 30±13 msec (p
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Background and Aim The GORE® CARDIOFORM septal occluder (GCO) is an atrial septal defect/patent foramen ovale (ASD/PFO) closure device with theoretical advantages over other commercialized devices thanks to its softness and anatomical compliance. Our aim was to evaluate the short and medium-term electrocardiographic changes after percutaneous ASD closure with GCO in a pediatric population. Methods We enrolled 39 patients with isolated ASD submitted to trans-catheter closure with GCO from January 2020 to June 2021. EKG was performed before (T0), at 24 hours (T1) and 6 months (T2) after ASD transcatheter closure. P wave dispersion was calculated as the difference between maximum and minimum P- wave duration, PR interval as the interval between beginning of the P wave and beginning of the QRS complex and QT dispersion as the difference between maximun and minimun of QTc intervals. At 6-months from device implantation, the patients were submitted to ambulatory EKG Holter recording. Results Patients’ age and BSA were 8.2±4.2 years (IQR 4.2-8.3, median 7.0) and 1.0±0.3 m2 (IQR 0.7-1.7, median 0.9), respectively. The strectched ASD diameter was 16.3±4.5 mm (median 16), resulting in QP/QS of 1.7±0.6 (median 1.5). At the baseline mean P wave dispersion was 40±15 msec and decreased to 30±13 msec (p&lt;0.002) at 24h, without any further change at 6 months (30±13 msec, p&lt;0.002). PR conduction significantly improved at 24 h from device implantation (from 175.0±20.8 to 144.0±22.7 msec, p=0.018) and did not significantly change at 6 months (164.0±19.5 msec, p=NS). QTc dispersion decreased at 24 hours (31.7±.20.3, p&lt;0.02) and at 6 months (28.0±18.1, p&lt;0.002) from device implantation. After device deployment, 2 pts (5%) developed transient, self-limited junctional rhythm and one of them needed a short course of anti-arrhythmic therapy for supra-ventricular tachycardia. No tachy/brady-arrhythmias were recorded at the 6-months follow-up EKG Holter monitoring. Conclusions Percutaneous ASD closure with the GCO device results in significant, sudden improvement of intra-atrial, atrio-ventricular and intraventricular electrical homogeneity. This benefit persists unaltered over a medium term follow-up. It might be due to a favourable volumetric remodelling that was not hindered by mechanical impact of the occluding prosthesis and could explain the low rate of arrhythmias found at the mid-term EKG evaluation.</description><identifier>ISSN: 1099-5129</identifier><identifier>EISSN: 1532-2092</identifier><identifier>DOI: 10.1093/europace/euac053.027</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>Europace (London, England), 2022-05, Vol.24 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2021. For permissions please email: Journals.permissions@oup.com. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Fumanelli, J</creatorcontrib><creatorcontrib>Garibaldi, S</creatorcontrib><creatorcontrib>Castaldi, B</creatorcontrib><creatorcontrib>Di Candia, A</creatorcontrib><creatorcontrib>Cuman, M</creatorcontrib><creatorcontrib>Pizzuto, A</creatorcontrib><creatorcontrib>Sirico, D</creatorcontrib><creatorcontrib>Mirizzi, G</creatorcontrib><creatorcontrib>Piacenti, M</creatorcontrib><creatorcontrib>Cantinotti, M</creatorcontrib><creatorcontrib>Assanta, N</creatorcontrib><creatorcontrib>Di Salvo, G</creatorcontrib><creatorcontrib>Santoro, G</creatorcontrib><title>Short-term electrocardiographic atrial remodelling after asd closure with the gco device in a pediatric population</title><title>Europace (London, England)</title><description>Abstract Funding Acknowledgements Type of funding sources: None. Background and Aim The GORE® CARDIOFORM septal occluder (GCO) is an atrial septal defect/patent foramen ovale (ASD/PFO) closure device with theoretical advantages over other commercialized devices thanks to its softness and anatomical compliance. Our aim was to evaluate the short and medium-term electrocardiographic changes after percutaneous ASD closure with GCO in a pediatric population. Methods We enrolled 39 patients with isolated ASD submitted to trans-catheter closure with GCO from January 2020 to June 2021. EKG was performed before (T0), at 24 hours (T1) and 6 months (T2) after ASD transcatheter closure. P wave dispersion was calculated as the difference between maximum and minimum P- wave duration, PR interval as the interval between beginning of the P wave and beginning of the QRS complex and QT dispersion as the difference between maximun and minimun of QTc intervals. At 6-months from device implantation, the patients were submitted to ambulatory EKG Holter recording. Results Patients’ age and BSA were 8.2±4.2 years (IQR 4.2-8.3, median 7.0) and 1.0±0.3 m2 (IQR 0.7-1.7, median 0.9), respectively. The strectched ASD diameter was 16.3±4.5 mm (median 16), resulting in QP/QS of 1.7±0.6 (median 1.5). At the baseline mean P wave dispersion was 40±15 msec and decreased to 30±13 msec (p&lt;0.002) at 24h, without any further change at 6 months (30±13 msec, p&lt;0.002). PR conduction significantly improved at 24 h from device implantation (from 175.0±20.8 to 144.0±22.7 msec, p=0.018) and did not significantly change at 6 months (164.0±19.5 msec, p=NS). QTc dispersion decreased at 24 hours (31.7±.20.3, p&lt;0.02) and at 6 months (28.0±18.1, p&lt;0.002) from device implantation. After device deployment, 2 pts (5%) developed transient, self-limited junctional rhythm and one of them needed a short course of anti-arrhythmic therapy for supra-ventricular tachycardia. No tachy/brady-arrhythmias were recorded at the 6-months follow-up EKG Holter monitoring. Conclusions Percutaneous ASD closure with the GCO device results in significant, sudden improvement of intra-atrial, atrio-ventricular and intraventricular electrical homogeneity. This benefit persists unaltered over a medium term follow-up. It might be due to a favourable volumetric remodelling that was not hindered by mechanical impact of the occluding prosthesis and could explain the low rate of arrhythmias found at the mid-term EKG evaluation.</description><issn>1099-5129</issn><issn>1532-2092</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNqNkMtOwzAURC0EEqXwByz8A2n9TPASVbykSiyAdXR7fdMYpXXkOCD-nlQte1YzizmzOIzdSrGQwukljSn2gDQVQGH1QqjqjM2k1apQwqnzqQvnCiuVu2RXw_AphKiUszOW3tqYcpEp7Th1hDlFhORD3Cbo24AccgrQ8US76Knrwn7LoZnmHAbPsYvDmIh_h9zy3BLfYuSevgISD3sOvCcfDg_I-9iPHeQQ99fsooFuoJtTztnH48P76rlYvz69rO7XBUotq6JUhoSvrPPeYIVCGWttoxxpLC1Wwtx5dE4KIHLlZmMa7SoHCsg4r0uj9ZyZ4y-mOAyJmrpPYQfpp5aiPnir_7zVJ2_15G3Clkcsjv3_iF_ubXdL</recordid><startdate>20220519</startdate><enddate>20220519</enddate><creator>Fumanelli, J</creator><creator>Garibaldi, S</creator><creator>Castaldi, B</creator><creator>Di Candia, A</creator><creator>Cuman, M</creator><creator>Pizzuto, A</creator><creator>Sirico, D</creator><creator>Mirizzi, G</creator><creator>Piacenti, M</creator><creator>Cantinotti, M</creator><creator>Assanta, N</creator><creator>Di Salvo, G</creator><creator>Santoro, G</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20220519</creationdate><title>Short-term electrocardiographic atrial remodelling after asd closure with the gco device in a pediatric population</title><author>Fumanelli, J ; Garibaldi, S ; Castaldi, B ; Di Candia, A ; Cuman, M ; Pizzuto, A ; Sirico, D ; Mirizzi, G ; Piacenti, M ; Cantinotti, M ; Assanta, N ; Di Salvo, G ; Santoro, G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1317-624e0d759dd4c7c024555f29e3c65c7048dc9910aee96bb4f3979a2ae49d36433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fumanelli, J</creatorcontrib><creatorcontrib>Garibaldi, S</creatorcontrib><creatorcontrib>Castaldi, B</creatorcontrib><creatorcontrib>Di Candia, A</creatorcontrib><creatorcontrib>Cuman, M</creatorcontrib><creatorcontrib>Pizzuto, A</creatorcontrib><creatorcontrib>Sirico, D</creatorcontrib><creatorcontrib>Mirizzi, G</creatorcontrib><creatorcontrib>Piacenti, M</creatorcontrib><creatorcontrib>Cantinotti, M</creatorcontrib><creatorcontrib>Assanta, N</creatorcontrib><creatorcontrib>Di Salvo, G</creatorcontrib><creatorcontrib>Santoro, G</creatorcontrib><collection>CrossRef</collection><jtitle>Europace (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fumanelli, J</au><au>Garibaldi, S</au><au>Castaldi, B</au><au>Di Candia, A</au><au>Cuman, M</au><au>Pizzuto, A</au><au>Sirico, D</au><au>Mirizzi, G</au><au>Piacenti, M</au><au>Cantinotti, M</au><au>Assanta, N</au><au>Di Salvo, G</au><au>Santoro, G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Short-term electrocardiographic atrial remodelling after asd closure with the gco device in a pediatric population</atitle><jtitle>Europace (London, England)</jtitle><date>2022-05-19</date><risdate>2022</risdate><volume>24</volume><issue>Supplement_1</issue><issn>1099-5129</issn><eissn>1532-2092</eissn><abstract>Abstract Funding Acknowledgements Type of funding sources: None. Background and Aim The GORE® CARDIOFORM septal occluder (GCO) is an atrial septal defect/patent foramen ovale (ASD/PFO) closure device with theoretical advantages over other commercialized devices thanks to its softness and anatomical compliance. Our aim was to evaluate the short and medium-term electrocardiographic changes after percutaneous ASD closure with GCO in a pediatric population. Methods We enrolled 39 patients with isolated ASD submitted to trans-catheter closure with GCO from January 2020 to June 2021. EKG was performed before (T0), at 24 hours (T1) and 6 months (T2) after ASD transcatheter closure. P wave dispersion was calculated as the difference between maximum and minimum P- wave duration, PR interval as the interval between beginning of the P wave and beginning of the QRS complex and QT dispersion as the difference between maximun and minimun of QTc intervals. At 6-months from device implantation, the patients were submitted to ambulatory EKG Holter recording. Results Patients’ age and BSA were 8.2±4.2 years (IQR 4.2-8.3, median 7.0) and 1.0±0.3 m2 (IQR 0.7-1.7, median 0.9), respectively. The strectched ASD diameter was 16.3±4.5 mm (median 16), resulting in QP/QS of 1.7±0.6 (median 1.5). At the baseline mean P wave dispersion was 40±15 msec and decreased to 30±13 msec (p&lt;0.002) at 24h, without any further change at 6 months (30±13 msec, p&lt;0.002). PR conduction significantly improved at 24 h from device implantation (from 175.0±20.8 to 144.0±22.7 msec, p=0.018) and did not significantly change at 6 months (164.0±19.5 msec, p=NS). QTc dispersion decreased at 24 hours (31.7±.20.3, p&lt;0.02) and at 6 months (28.0±18.1, p&lt;0.002) from device implantation. After device deployment, 2 pts (5%) developed transient, self-limited junctional rhythm and one of them needed a short course of anti-arrhythmic therapy for supra-ventricular tachycardia. No tachy/brady-arrhythmias were recorded at the 6-months follow-up EKG Holter monitoring. Conclusions Percutaneous ASD closure with the GCO device results in significant, sudden improvement of intra-atrial, atrio-ventricular and intraventricular electrical homogeneity. This benefit persists unaltered over a medium term follow-up. It might be due to a favourable volumetric remodelling that was not hindered by mechanical impact of the occluding prosthesis and could explain the low rate of arrhythmias found at the mid-term EKG evaluation.</abstract><pub>Oxford University Press</pub><doi>10.1093/europace/euac053.027</doi><oa>free_for_read</oa></addata></record>
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title Short-term electrocardiographic atrial remodelling after asd closure with the gco device in a pediatric population
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