The Outcomes of Transcatheter Closure of Secundum Atrial Septal Defects on Cardiac Remodeling by Electrocardiography and Holter Study in Pediatric Population

Background: A significant atrial septal defect leads to atrial interstitial fibrosis, arrythmia and right ventricle remodelling. Objective: This study aimed to investigate the outcomes of transcatheter closure of secundum atrial septal defects on cardiac remodelling by electrocardiography and Holter study in pediatric population Patients and Methods This prospective observational study was conducted on 69 patients (35 males and 34 females), aged from 1.5 to 16 years, diagnosed with secundum ASD who were referred for elective transcatheter secundum ASD device closure at Department of Pediatrics, Faculty of Medicine, Sohag University Hospitals, between April 2022 and June 2023. Results: There was a significant reduction in all ECG parameters including HR, PR interval, QRS duration, QRS Axis and QTc interval immediately, one day post-procedure, after 1 month, 6 months and after 1year compared to pre-transcatheter (P value<0.05). Sinus tachycardia, prolonged QTC duration, prolonged PR interval, prolonged QRS duration and rt axis deviation were insignificantly different between males and females pre transcatheter, post transcatheter ASD closure. Heart rate variability indices (Pnn50, RMS-SD, SDNN, SDANN and tri) were significantly higher one day post transcatheter, also after one month, after 6 months and after one year compared to the baseline values pre-closure (P value 0.05). Conclusions:It could be concluded that transcatheter ASD device closure leads immediately to a significant improvement in electrical reverse remodelling parameters. Holter ECG study is considered a beneficial tool to evaluate cardiac autonomic functions and the influence of transcatheter closure of ASD on cardiac autonomic function and magnitude of arrhythmia.