Cor Vasa 2026, 68(4):455-460 | DOI: 10.33678/cor.2026.029

Device Size/Septal Length as Predictors of Atrial Fibrillation After Percutaneous ASD Closure: 15-Year Follow-Up.

Ahmet Özderya^a, Fatih Gülçebi^a, Murat Gökhan Yerlikaya^b, Ali Riza Akyüz^b

^a Department of Cardiology, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey

^b Department of Cardiology, University of Health Sciences Trabzon Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey

Background: Atrial fibrillation (AF) is known to develop during the follow-up of patients who have undergone percutaneous atrial septal defect (ASD) closure. The primary aim of our study was to investigate the development and predictors of AF in the long-term follow-up of patients after ASD closure.

Methods: Fifty-six patients who underwent percutaneous ASD closure at our center between 2008 and 2010 were included in the study. The study population was divided into two groups: patients with and those without an AF diagnosis.

Result: There were 13 patients with AF (two males, 11 females; age = 41.02 ± 7.02 years; left ventricle ejection fraction [LVEF] = 62.39 ± 8.32%) and 43 patients without AF (seven males, 36 females; age = 39.55 ± 9.26 years; LVEF = 64.76 ± 8.08%). In regression analysis, only the device size/total septum length ratio was found to be an independent predictor of long-term AF development.

Conclusions: This study revealed that an increased device size/total septum length ratio was associated with the development of AF in the long term. We recommend that operators use the smallest size closure device that adequately covers the defect. © 2026, ČKS.

Keywords: Atrial fibrillation, Atrial septal defect, Device size, total septum length

Received: December 17, 2025; Revised: March 5, 2026; Accepted: March 14, 2026; Prepublished online: August 24, 2026; Published: August 31, 2026  Show citation