Congenital heart diseaseCohort study
Closure of secundum atrial septal defect and risk of incident and recurrent arrhythmia
- Danish nationwide cohort study
- time-dependent Cox regression analyses
Authors' conclusion
The incidence rate of arrhythmia among patients with ASD was 13 per 1000 PY, with age and closure technique being pivotal factors. Surgical closure was associated with an increased risk of arrhythmias compared with no closure, whereas percutaneous closure was associated with a decreased risk of recurrence.
Study context
- Population
- All patients diagnosed with secundum atrial septal defect (ASD) (1977–2024), followed until arrhythmia, death, emigration, or study end (January 2024)patients with ASD (43.3% men), 34.6% underwent ASD closure (65.5% surgically and 34.5% percutaneously)
- Participants
- 6,469 patients
- Exposure
- The risk of (recurrent) arrhythmias was assessed based on ASD closure status and closure technique.
Main finding
As reported in the abstract
Incidence rate of arrhythmia
Incidence rate of arrhythmia per 1000 person-years (PY)
13.3 (95% confidence interval [CI], 12.6-14.2)
Observational data: associations, not effects.
Further findings
| Outcome | adjusted HR (95% CI) | |
|---|---|---|
| Arrhythmias | 1.38 (1.19–1.60) | |
| Arrhythmia recurrence · decreased risk of recurrence with percutaneous closure | 0.79 (0.64–0.98) | |
| 0.512Adjusted hazard ratio (log scale) |
- Arrhythmia recurrence — Overall, patients experiencing arrhythmia recurrence
- 3 in 4
- Arrhythmias: increased risk with surgical closure; time-dependent Cox regression
Age at diagnosis and closure and arrhythmia
- Older age at diagnosis and closure were linked to higher incidence and recurrence of arrhythmia
Arrhythmias
- no difference was found for percutaneous closure
Arrhythmia recurrence
- ASD closure was associated with a decreased risk of recurrence; statistical significance only for percutaneous closure vs no closure
Original publication
Closure of secundum atrial septal defect and risk of incident and recurrent arrhythmia. Heart Rhythm. Published 23 January 2026. doi:10.1016/j.hrthm.2026.01.024
Summarised from the published abstract; every number is checked against it