Background: The aim of this paper is to present our own experience related to frequency of
symptomatic tachy- and bradyarrhythmias in patients after transcatheter closure of interatrial
defects (ASD) and patent foramen ovale (PFO) using Amplatzer plugs.
Methods: Transcatheter closure of interatrial communications with Amplatzer devices was
carried out on 739 patients in our center. Only patients with new symptomatic arrhythmias
(who required pharmacotherapy, cardioversion or pacemaker implantation) were included in
to the study. All patients who had had arrhythmias prior to ASD closure, such as supraventricular
tachycardias (SVT) or atrial flutter/fibrillation (AF), were excluded.
Results: New tachy- and bradyarrhythmias after implantation of Amplatzer devices were
observed in 11 patients (1.5%). There were 9 patients (mean age 36.7 years) with atrial
tachyarrhythmias (AF in 8 and SVT in 1 patients), which occurred between the first day and
3 months after implantation. Seven patients were treated initially by pharmacotherapy; in 2 of
them sinus rhythm returned just after cardioversion. In other 2 patients cardioversion was
performed as an initial therapy. In none of these patients, but one recurrence of tachycardia was
observed; however, 7 of them had pharmacotherapy prolonged up to 1 year. In 2 patients, aged
15 and 16, complete atrioventricular (AV) block was observed 4.3 and 1.5 years after Amplatzer
implantation, respectively. In the first patient intermittent second-degree AV block (Mobitz II) was
observed before ASD closure. In both patients, a DDDR pacemaker was implanted.
Conclusions: Transcatheter closure of ASD using Amplatzer devices is associated with a risk
of new atrial tachyarrhythmias (usually early after the procedure and in older patients). The
risk of conduction disturbances such as complete heart block, which can occur in late followup,
is low. Thence, close long-term follow-up of these patients is obligatory