{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:06:22Z","timestamp":1788822382899,"version":"build-2803163510"},"reference-count":21,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100004046","name":"Karen Elise Jensens Fond","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004046","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007605","name":"Aarhus Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007605","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2019,6,13]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In recent Danish nationwide register-based study, adults with small, unrepaired atrial septal defects (ASD) have increased risk of pneumonia, atrial fibrillation (AF) and stroke. Moreover, they revealed higher mortality than the background population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>In this nationwide study, we evaluate the hidden burden of atrial and ventricular arrhythmias in adult patients with a small, unrepaired ASD without a previous diagnosis of AF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All Danish patients, aged 18\u201365, diagnosed between 1953 and 2011 with an unrepaired ASD and no documented AF were invited for 7 days Holter-recording, echocardiography and 6\u2009min walk test. The first 48\u2009hours Holter-recording was completely analysed, while only AF was screened for throughout all 7\u2009days. Furthermore, the entire patient group were characterised using the unique Danish registries.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 151 patients (mean age 32 years) were included. Approximately 80% of the patients had spontaneous closure of their defect. Despite this, occult arrhythmias were frequent. The most common arrhythmia was supraventricular tachycardia (n=24, 16%) with non-sustained atrial arrhythmias in 21 patients and AF in two patients. A considerable number of patients had non-sustained ventricular tachycardia (n=12, 8%). Patients with ASD and tachyarrhythmias had increased right ventricular to left ventricular diastolic area in echocardiography and higher age when compared with ASD patients without arrhythmias.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Adult patients with small, unrepaired ASD have a hidden burden of both atrial and ventricular tachyarrhythmias. The mechanism likely relates to the residua of previous right-heart volume overload and incomplete reverse remodelling. Our results support guidelines recommending continued follow-up of patients with small, unrepaired ASD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2019-001056","type":"journal-article","created":{"date-parts":[[2019,6,29]],"date-time":"2019-06-29T13:04:07Z","timestamp":1561813447000},"page":"e001056","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Hidden burden of arrhythmias in patients with small atrial septal defects: a nationwide study"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3929-5120","authenticated-orcid":false,"given":"Sebastian","family":"Udholm","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Nyboe","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Redington","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology, Department of Pediatrics, Cincinnati Children\u2019s Hospital, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens Erik","family":"Nielsen-Kudsk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens Cosedis","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8047-0015","authenticated-orcid":false,"suffix":"DMSc, PhD","given":"Vibeke Elisabeth","family":"Hjortdal","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,6,29]]},"reference":[{"key":"2025081709435113000_6.1.e001056.1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.204933"},{"key":"2025081709435113000_6.1.e001056.2","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1093\/eurheartj\/ehx687","article-title":"Long-term mortality in patients with atrial septal defect: a nationwide cohort-study","volume":"39","author":"Nyboe","year":"2018","journal-title":"Eur Heart J"},{"key":"2025081709435113000_6.1.e001056.3","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.ijcard.2019.02.024","article-title":"Lifelong burden of small unrepaired atrial septal defect: results from the Danish national patient 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