Atrial fibrillation in atrial septal defects: a problem of right atrium or left atrium?

摘要

Atrial fibrillation and atrial flutter are the most common cardiac arrhythmias associated with atrial septal defects (ASD) in adult patients. The incidence could be as high as 52% in patients ages 60 years or more.1 Previous observational studies have shown that preexisting atrial flutter or atrial fibrillation and patient age more than 40 are two independent predictors for postoperative recurrence of atrial tachyarrhythmias (mainly atrial fibrillation), despite the universal regression of right-sided cardiac chamber dilatation, augmentation of left ventricle preload, and total cardiac output after surgical ASD closure.Nevertheless, studies regarding the pathophysiological or electrophysiological mechanism(s) underlying the high incidence of atrial fibrillation in adult patients with ASD remain relatively few, which would limit a best possible strategy design in clinical management.