Postępy w Kardiologii Interwencyjnej

Abstract

3/2024 vol. 20
Original paper

Cardiac troponin I release after transcatheter closure of atrial septal defects is associated with supraventricular arrhythmias on early follow-up

  1. Department of Cardiac and Vascular Diseases, John Paul II Hospital, Institute of Cardiology, Krakow, Poland
  2. Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
Adv Interv Cardiol 2024; 20, 3 (77): 338–344
Online publish date: 2024/08/14
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Introduction:

Atrial septal defects (ASD) are prevalent congenital heart anomalies found in the adult population. Percutaneous ASD closure has become a routine clinical practice. Elevation of postprocedural transient cardiac biomarkers and exacerbation of supraventricular arrhythmias have been reported in the subject literature.

Aim:

To explore the relationship between cardiac troponin I (cTnI) elevation and supraventricular ectopy (SVE) following percutaneous closure of secundum atrial septal defect (ASD) in adult patients.

Material and methods:

600 consecutive patients who underwent successful transcatheter ASD secundum closure were analyzed. Serum levels of cTnI were measured before and within 72 h of device implantation. 24-hour Holter monitoring was performed before the procedure, at 1 month, and at 6 months of follow-up.

Results:

SVE burden increased 1 month after the procedure (median 1021.00; min.–max. 11.00–29 862.00) compared to baseline values (median 146.00; min.–max. 0–1865.00; p < 0.01). 61.7% of patients demonstrated a cTnI rise exceeding 50% of the upper reference limit within 24 h of the procedure. A statistically significant positive correlation between SVE burden 1 month after the procedure and periprocedural cTnI increase (p < 0.05, r = 0.41) was observed, while cTnI levels significantly correlated with procedure and fluoroscopy time (p < 0.001), device size (p < 0.001) and maximal ASD diameter (p < 0.001).

Conclusions:

A significant increase of cTnI is noted frequently after transcatheter ASD closure and seems to predict exacerbation in SVE burden on short-term follow up. The independent risk factors of cTnI rise are prolonged procedure duration and larger device sizes.

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