Cardiology in the Young (2013), 23, 132–137 doi:10.1017/S1047951112000418 r Cambridge University Press, 2012 Brief Report Comparative effects of surgical and percutaneous repair on P-wave and atrioventricular conduction in patients with atrial septal defect – ostium secundum type Hassan Javadzadegan, 1 Mehrnoush Toufan, 1 Ali Reza Sadighi, 2 Joyce M. Chang, 3 Nader D. Nader 3 1 Department of Cardiology; 2 Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 3 Department of Anesthesiology, University at Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York, United States of America Abstract Both surgical and percutaneous closures of atrial septal defects have been successful in reversal of atrial dilatation. We compared the effects of surgical and percutaneous transvenous device closure of atrial septal defect on post-operative changes of P-wave duration, PR segment, and PR interval. Electrocardio- graphic data were prospectively collected from 30 patients following either surgical (n equal to 16) or percutaneous (n equal to 16) repair of atrial septal defects between 2004 and 2010. A cardiologist blinded to the closure technique performed the electrocardiographic analyses. P-wave duration (98.5 plus or minus 15.4 to 86.4 plus or minus 13.2 milliseconds, p-value less than 0.05) and PR interval (162.9 plus or minus 18.5 to 140.6 plus or minus 15.2 milliseconds, p-value less than 0.05) were reduced after percutaneous transvenous device closure. P-wave duration (104.5 plus or minus 24.7 versus 83.2 plus or minus 13.3 milliseconds, p-value less than 0.05) and PR interval (173.2 plus or minus 38.7 versus 144.3 plus or minus 32.0 milliseconds, p-value less than 0.05) were also reduced after surgical closure. PR segment in the percutaneous group was significantly reduced (63.4 plus or minus 14.5 to 52.1 plus or minus 10.8 milliseconds, p-value less than 0.05), but not in the surgical group (68.6 plus or minus 18.7 versus 61.1 plus or minus 24.7 milliseconds). However, the difference in PR segment changes between the two groups was not significant (211.3 plus or minus 15.0 versus 27.6 plus or minus 20.5 milliseconds, p-value equal to 0.18). Our analysis demonstrates that the changes between the two groups were not different and that both closure techniques reduce P-wave duration, PR segment, and PR interval within 6 months. Keywords: Cardiac shunts; electrocardiogram; congenital heart disease; device closure Received: 13 July 2011; Accepted: 6 March 2012; First published online: 5 April 2012 A TRIAL SEPTAL DEFECT IS ONE OF THE MOST common forms of congenital heart diseases, defined as a defect in the interatrial septum. 1,2 On the basis of the anatomic position of the defect, it is divided into four subtypes including ostium secundum or fossa ovalis type (75%), ostium primum type (15%), sinus venosus type (10%), and coronary sinus defects. 3 Due to the atrial remodelling that occurs in patients with septal defects that confer a higher risk to arrhyth- mias. Therefore, closure of the defect is important because of the increased risk of arrhythmias in addition to haemodynamic consequences and throm- boembolic events. 4 Both surgical and percutaneous transvenous device techniques have been utilised to Correspondence to: Dr Nader D. Nader, MD, PhD, Professor of Anesthesiology, VA Western New York Healthcare System, 3495 Bailey Avenue, Buffalo, New York 14215, United States of America. Tel: 1716 862 8707; Fax: 1716 862 6723; E-mail: nnader@buffalo.edu