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Atrial septal puncture, circumferential pulmonary vein vestibular isolation, left atrial appendage occlusion, atrial septal occlusion has become a fashion.1 But there's a problem. Atrial fibrillation.
How to solve atrial fibrillation after transcatheter closure of atrial septal defect?
The electrophysiological mechanism (focal trigger mechanism, multiple subwaves, etc.) and pathophysiological mechanism (electrical remodeling, systolic remodeling, structural remodeling, etc.) of atrial fibrillation (AF).Mechanism of AF in patients with atrial septal defect(ASD): Patients with ASD are prone to AF due to long-term excessive volume load on the atrium.The other mechanisms of AF after transcatheter closure include inflammatory reaction caused by local traction or stimulation, new reentry loop formed by occluder as electrical conduction barrier, morphological and functional changes of atrial matrix before transcatheter closure.
AF is a common complication of secundum ASD in adults. It is often caused by long-term expansion and remodeling of right atrium, and the prevalence increases with age. The presence of ASD changes the hemodynamics of the heart and leads to structural and electrical remodeling of the heart, which leads to the occurrence of AF. The occurrence of AF further aggravates the structural and electrical remodeling, forming a vicious circle.
AF often occurs in patients with atrial defect due to atrial enlargement and...Competing Interests: None declared.