[Atrial arrhythmias after surgical repair of an atrial septal defect (secundum-type). Six years follow-up in adults (author's transl)].

Atrial arrhythmias before and after repair of an atrial septal defect (secundum-type) were analyzed in 100 patients. The mean postoperative follow-up was 5.8 years, the mean age at the last check-up was 33.4 years. Preoperatively, 10 patients showed atrial arrhythmias (6 pts atrial flutter or fibrillation [AF], 3 pts sinus node [SN] dysfunction, 1 pt atrial tachycardia). About 6 years after operation, 29 patients showed atrial arrhythmias (16 pts AF, 10 pts SN dysfunction, 3 pts atrial tachycardias). The 26 patients with AF and SN dysfunction were 10 years older and had a 3 years longer follow-up period postoperatively than those with sinus rhythm. In addition, they had a higher pulmonary artery pressure preoperatively. Especially the occurrence of AF after operation was strongly related to the age and the pulmonary artery pressure. All other factors had no significance. The data show that closure of an atrial septal defect cannot prevent the occurrence of AF in the following period. In addition, SN dysfunction is found postoperatively in a significant number of patients probably due to the intraoperative injury to the sinus node. However, it cannot be excluded that the unfavorable results may in part be due to the selection of the patients.