Long-Term Risk of Atrial Fibrillation and Stroke in Patients With Atrial Septal Defect Diagnosed in Childhood

The aim of this study was to evaluate the long-term risk of atrial fibrillation (AF) and stroke in patients with atrial septal defect (ASD) diagnosed before the age of 18 years. Patients diagnosed with ASD from 1963 to 2011 were identified through national Danish registers, of which 1,111 fulfilled the inclusion criteria. Each patient was matched with 10 control subjects on age and gender. Risk of AF and stroke was assessed using Cox proportional hazards regression. Cumulative incidences were calculated using Fine and Gray competing risk regression. Median follow-up time was 24 years (range 1 to 49 years). Patients with ASD had a significantly increased risk of AF; both with closure (adjusted hazard ratio [HR] 18.5, 95% confidence interval [CI] 7.8 to 44.1, p