Risk factors for atrial fibrillation in adult patients in long-term observation following surgical closure of atrial septal defect type II

Background: The aim of the study was to find the factors predictive for paroxysmal atrial fibrillation (AF) following surgical correction of atrial septal defect type II (ASD t.II). Methods: 93 patients, who underwent isolated surgical closure of ASD t.II between 1990 and 2001 were included. Follow-up studies were performed 2 - 11 years after surgery. Patients were divided into two groups according to the presence of AF before and after surgery. Group AF (+) consisted of 29 and group AF (-) of 64 patients. All patients underwent echocardiography, electrocardiogram (ECG) at rest, and signal-averaged P-wave duration (PWD) in signal-averaged ECG. The following parameters were assessed in echocardiography: pulmonary artery systolic pressure, left and right atrial dimensions, right ventricular dimension, tricuspid and mitral regurgitation. Results: Paroxysmal AF was observed in 27 patients before surgery and in 29 after surgery. Analyzing all potential risk factors we proved that PWD may independently predict occurrence of postoperative AF. Conclusion: PWD may independently predict postoperative AF in long-term follow-up after surgical correction of ASD t.II.