{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:00:33Z","timestamp":1789768833930,"version":"4.0.1"},"reference-count":38,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:00:00Z","timestamp":1696204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and aim: The GORE\u00ae CARDIOFORM (GCO) septal occluder is an atrial septal defect\/patent foramen ovale closure device with theoretical advantages over other commercialized devices thanks to its softness and anatomical compliance. Our aim was to evaluate the short- and medium-term electrocardiographic changes after percutaneous ASD closure with GCO in a pediatric population. Methods: We enrolled 39 patients with isolated ASD submitted to trans-catheter closure from January 2020 to June 2021. ECG was performed before, at 24 h and 6 months after the procedure. P wave dispersion, QTc and QTc dispersion were calculated. ECG Holter was recorded at 6 months after implantation. Results: Patients\u2019 age and body surface area (BSA) were 8.2 \u00b1 4.2 years and 1.0 \u00b1 0.3 m2 respectively. At the baseline, mean P wave dispersion was 40 \u00b1 15 msec and decreased at 24 h (p &lt; 0.002), without any further change at 6 months. At 24 h, PR conduction and QTc dispersion significantly improved (p = 0.018 and p &lt; 0.02 respectively), while the absolute QTc value considerably improved after 6 months. During mid-term follow-up, QTc dispersion remained stable without a significant change in PR conduction. The baseline cardiac frequency was 88.6 \u00b1 12.6 bpm, followed by a slight reduction at 24 h, with a further amelioration at 6 months after the procedure (87.3 \u00b1 14.2, p = 0.9 and 81.0 \u00b1 12.7, p = 0.009, respectively). After device deployment, two patients developed transient, self-limited junctional rhythm. One of them needed a short course of Flecainide for atrial ectopic tachycardia. No tachy\/brady-arrhythmias were recorded at the 6-month follow-up. ASD closure resulted in a marked decrease in right heart volumes and diameters at 6 months after percutaneous closure. Conclusions: Percutaneous ASD closure with the GCO device results in significant, sudden improvement of intra-atrial, atrio-ventricular and intraventricular electrical homogeneity. This benefit persists unaltered over a medium-term follow-up. These electrical changes are associated with a documented positive right heart volumetric remodeling at mid-term follow-up.<\/jats:p>","DOI":"10.3390\/jcm12196334","type":"journal-article","created":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T04:39:30Z","timestamp":1696221570000},"page":"6334","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Mid-Term Electrical Remodeling after Percutaneous Atrial Septal Defect Closure with GCO Device in a Pediatric Population"],"prefix":"10.3390","volume":"12","author":[{"given":"Jennifer","family":"Fumanelli","sequence":"first","affiliation":[{"name":"Pediatric Cardiology Unit, Woman\u2019s and Child\u2019s Health Department, Padua University, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Garibaldi","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanit\u00e0 Pubblica, Electrophysiology Division, 56124 Pisa, Italy"},{"name":"Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanit\u00e0 Pubblica, Pediatric Cardiology and GUCH Unit, Heart Hospital \u201cG. Pasquinucci\u201d, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biagio","family":"Castaldi","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Woman\u2019s and Child\u2019s Health Department, Padua University, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3500-8056","authenticated-orcid":false,"given":"Angela","family":"Di Candia","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Woman\u2019s and Child\u2019s Health Department, Padua University, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Pizzuto","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanit\u00e0 Pubblica, Pediatric Cardiology and GUCH Unit, Heart Hospital \u201cG. Pasquinucci\u201d, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Sirico","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Woman\u2019s and Child\u2019s Health Department, Padua University, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Cuman","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanit\u00e0 Pubblica, Pediatric Cardiology and GUCH Unit, Heart Hospital \u201cG. Pasquinucci\u201d, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Mirizzi","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanit\u00e0 Pubblica, Electrophysiology Division, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4801-608X","authenticated-orcid":false,"given":"Pietro","family":"Marchese","sequence":"additional","affiliation":[{"name":"Fondazione G. Monasterio CNR-Regione Toscana, Pediatric Cardiology and Cardiac Surgery, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Cantinotti","sequence":"additional","affiliation":[{"name":"Fondazione G. Monasterio CNR-Regione Toscana, Pediatric Cardiology and Cardiac Surgery, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Piacenti","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanit\u00e0 Pubblica, Electrophysiology Division, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Assanta","sequence":"additional","affiliation":[{"name":"Fondazione G. Monasterio CNR-Regione Toscana, Pediatric Cardiology and Cardiac Surgery, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Viacava","sequence":"additional","affiliation":[{"name":"Fondazione G. Monasterio CNR-Regione Toscana, Pediatric Cardiology and Cardiac Surgery, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0305-0113","authenticated-orcid":false,"given":"Giovanni","family":"Di Salvo","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, Woman\u2019s and Child\u2019s Health Department, Padua University, 35122 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6342-7843","authenticated-orcid":false,"given":"Giuseppe","family":"Santoro","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio per la Ricerca Medica e di Sanit\u00e0 Pubblica, Pediatric Cardiology and GUCH Unit, Heart Hospital \u201cG. Pasquinucci\u201d, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/S0735-1097(02)01886-7","article-title":"The incidence of congenital heart disease","volume":"39","author":"Hoffman","year":"2002","journal-title":"J. Am. Coll. Cardiol"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2915","DOI":"10.1093\/eurheartj\/ehq249","article-title":"ESC guidelines for the management of grown-up congenital heart disease (new version 2010)","volume":"31","author":"Baumgartner","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S2874","DOI":"10.21037\/jtd.2018.08.111","article-title":"Atrial septal defect closure: Indications and contra-indications","volume":"10","author":"Fraisse","year":"2018","journal-title":"J. Thorac. 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