Segmental Atrial Function Following Percutaneous Closure of Atrial Septum Using Occluder Device

Objectives: The aim of this study was to quantify segmental atrial function in patients 6 months after the insertion of atrial septal occluder (ASO) devices. Methods: Patients with ASO devices (n=23) were followed up for 6 months after device insertion and compared with a normal age-matched cohort (n=30). A subgroup of 13 patients were studied before, immediately after, and 6 months after device insertion. Using color Doppler tissue imaging (CDTI), segmental atrial contraction was measured from annular, middle, and superior segments in the apical 4-chamber and 2-chamber views of the left atrium and in the apical 4-chamber view of the right atrium. Peak positive strain and strain rate in early and late diastole were measured from superior segments in both the left and right atria. Results: Segmental atrial CDTI velocities, strain, and strain rates were reduced in the septal segments in the ASO group compared with controls. Furthermore, global left atrial strain and strain rate in early diastole were also significantly decreased. Atrial dysfunction in the septal segments was evident immediately after device insertion. Conclusion: Patients with ASO devices have significant global and segmental dysfunction in the atrial septal segments, as measured by CDTI, strain, and strain rate. The localized regional dysfunction is likely due to the direct mechanical effect associated with ASO device insertion. This may have implications for long-term atrial function and the need for anticoagulation. (J Am Soc Echocardiogr 2009; 22: 508-516.)