The Evaluation of P‐Wave Parameters in Patients With Percutaneous Closure of Atrial Septal Defect

TL;DR

This study shows that closing a heart defect called atrial septal defect (ASD) leads to immediate improvements in electrical signals in the heart, likely due to reduced volume overload.

Contribution

The study demonstrates immediate post-procedural changes in P-wave parameters following ASD closure, linking them to acute volume overload cessation.

Findings

P-wave duration (Pmax) and P-wave dispersion (PWD) significantly decreased after ASD closure.

Pmax values correlated with ASD size and patient age, but not with PWD.

There was no significant correlation between PWD and defect size or duration of overload.

Abstract

Atrial septal defect (ASD) can lead to volume overload and related changes in P‐wave parameters in surface electrocardiograms of these patients. In this study, we aimed to evaluate the effect of volume overload on P‐wave parameters in patients with ASD.

This study is a retrospective cohort analysis. A total of 142 patients with secundum ASD who underwent percutaneous closure were evaluated. P‐wave duration (Pmax) and P‐wave dispersion (PWD) were measured on the surface ECG before and 1 h after the closure procedure. We evaluated P‐wave parameters in terms of defect size, duration of the volume overload, and closure device sizes.

Pmax and PWD were significantly decreased after the procedure compared with the values before the procedure (p < 0.001). Pmax values had a statistically significant correlation with ASD size (< 20 mm or ≥ 20 mm) both before and after the procedure. Pmax values were significantly higher in patients older than 30 years of age (119.6 ± 19.5 vs. 102.7 ± 17.1 ms, respectively; p = 0.039). A significantly positive correlation was found between pre‐ and post‐procedural Pmax and defect sizes (r = 0.474, p = 0.019 and r = 0.4233, p = 0.04, respectively). However, no positive correlation between PWD and defect age and size was present.

Percutaneous closure of ASD is associated with an immediate decrease in both Pd and Pmax that seems to be related to the acute volume overload cessation in cardiac chambers.

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