{"id":"c25d977f3026","type":"article","url":"https://hartvaat.nl/2026/09/12/nieuwe-atriumfibrillatie-na-pfo-sluiting-komt-bij-1-op-9-voor-retrospectieve-coh/","title":"Nieuwe atriumfibrillatie na PFO-sluiting komt bij 1 op 9 voor — retrospectieve cohortstudie","title_en":"Long-term incidence and risk factors of atrial fibrillation after percutaneous patent foramen ovale occlusion: a retrospective cohort study.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Open heart","doi":"10.1136/openhrt-2026-004344","source_url":"https://doi.org/10.1136/openhrt-2026-004344","authors":["Oscar Rommens","Maarten Blondeel","Mathias Maes","Marie-Paule Goidts","Christophe Garweg","Els Troost","Peter Haemers","Tomas Robyns","Alexander Van De Bruaene","Joris Ector","Rik Willems","Werner Budts","Pieter De Meester","Bert Vandenberk"],"significance":5,"published":"2026-09-21","source_date":"2026-09-12","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/ritmecontrole-af/","https://hartvaat.nl/kennis/atriumfibrilleren/esc-richtlijn-af-2024/"],"congress":"","summary_en":"In a retrospective cohort of 867 patients undergoing percutaneous PFO closure between 1999 and 2021, 11.2% developed new-onset atrial fibrillation over a median follow-up of 11.7 years. More than a quarter of these cases occurred within the first three months post-procedure. Older age, larger occluder device size, and moderate-to-severe valvular regurgitation were independently associated with AF development. These findings highlight the need for targeted rhythm monitoring, particularly in the early post-procedural period and among patients with identifiable risk factors.","created":"2026-09-14T01:09:39Z","updated":"2026-09-14T01:09:39Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een retrospectieve cohortstudie onder 867 patiënten die tussen 1999 en 2021 een percutane PFO-sluiting ondergingen, ontwikkelde 11,2% nieuwe atriumfibrillatie tijdens een mediane follow-up van 11,7 jaar. Ruim een kwart van de episodes trad op binnen de eerste drie maanden na de ingreep. Multivariabele analyse toonde aan dat hogere leeftijd, een groter sluitapparaat en matige tot ernstige klepinsufficiëntie onafhankelijk met het risico op AF samenhangen. Deze bevindingen ondersteunen het belang van gerichte ritmecontrole, vooral in de vroege postprocedurale fase en bij patiënten met de geïdentificeerde risicofactoren.","abstract_original":"BACKGROUND: Percutaneous patent foramen ovale (PFO) closure is an established intervention for secondary prevention of cryptogenic stroke. Increasing evidence indicates that the procedure is associated with a risk of new-onset atrial fibrillation (AF). This study aimed to describe the temporal distribution and clinical factors associated with new-onset AF following percutaneous PFO closure. METHODS: Patients aged ≥16 years undergoing percutaneous PFO closure between 1999 and 2021 at a tertiary care centre were retrospectively included. New-onset AF was identified through systematic review of electronic health records. Descriptives are presented as median with IQR. Time-to-event analysis was performed using cumulative incidence functions and Cox proportional hazards regression. RESULTS: Among 867 patients (median age 51 years (42-58), 47% female), PFO closure was performed for secondary stroke prevention in 86%. During a median follow-up of 11.7 years (6.3-16.8), new-onset AF occurred in 97 patients (11.2%), corresponding to an incidence rate of 1.0 per 100 patient-years. AF diagnoses clustered early after closure, with 26.8% occurring within the first 3 months. In multivariable analysis, higher age at closure (HR 1.05 per year; 95% CI 1.03 to 1.07), larger occluder device size (HR 1.09 per mm; 95% CI 1.03 to 1.16) and any moderate or severe valvular regurgitation (HR 3.70; 95% CI 1.65 to 8.33) were independently associated with new-onset AF. CONCLUSIONS: New-onset AF is common after PFO closure and shows early postprocedural clustering. Increasing age, larger occluder size and valvular regurgitation are independently associated with AF occurrence, underscoring the need for focused rhythm surveillance after closure."}