eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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abstract:
Original paper

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

Paweł Prochownik
1
,
Klaudia Bielecka
1
,
Tadeusz Przewłocki
1
,
Zuzanna Sachajko
2
,
Urszula Gancarczyk
1
,
Piotr Wilkołek
1
,
Michał Tworek
1
,
Piotr Podolec
1
,
Larysa Bielecka
2
,
Monika Komar
1

  1. Department of Cardiac and Vascular Diseases, John Paul II Hospital, Institute of Cardiology, Krakow, Poland
  2. Jagiellonian University Medical College, Faculty of Medicine, Krakow, Poland
Adv Interv Cardiol
DOI: https://doi.org/10.5114/aic.2024.142326
Online publish date: 2024/08/19
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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.

keywords:

electrocardiography, arrhythmia, echocardiography, interventional cardiology, congenital heart disease, myocardial damage
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