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- Title
High rate of persistent iatrogenic atrial septal defect after single transseptal puncture for cryoballoon pulmonary vein isolation.
- Authors
Linhart, Markus; Werner, Jessica T.; Stöckigt, Florian; Kohlmann, Annika T.; Lodde, Pia C.; Linneborn, Lutz P. T.; Beiert, Thomas; Hammerstingl, Christoph; Borràs, Roger; Nickenig, Georg; Andrié, René P.; Schrickel, Jan W.
- Abstract
<bold>Purpose: </bold>Congenital atrial septal defect (ASD) is associated with increased morbidity, whereas little is known about the rate of spontaneous closure, associated clinical and echocardiographic parameters, or complications of iatrogenic atrial septal defect (iASD) beyond 1 year of follow-up. Persistent iASD after transseptal puncture for PVI has been described in up to 38% of small cohorts of patients in short-term follow-up after transseptal puncture. We sought to investigate the course of iASD after single transseptal puncture for first pulmonary vein isolation (PVI) with cryoballoon, along with possible risk factors for persistent iASD.<bold>Methods: </bold>After a first PVI with cryoballoon, 102 patients (64 ± 10 years, 64% male) underwent long-term clinical follow-up and comprehensive transthoracic and transesophageal echocardiographic study.<bold>Results: </bold>Prevalence of iASD after PVI was 37% after 2.9 (1.6-4.9) years. No clinical complications or deterioration of echocardiographic parameters were associated with iASD. Lower left atrial appendage flow velocity was associated with higher risk of persistence of iASD (3.5% for every 1 cm/s decrease, p = 0.002).<bold>Conclusions: </bold>Despite a high rate of iASD after cryoballoon PVI in long-term follow-up, this was not associated with increased clinical complications. Lower LAA velocity was associated with higher risk of persistent iASD. Repeated routine echocardiographic follow-up may not be necessary in these patients.
- Subjects
IATROGENIC diseases; ATRIAL septal defects; CONGENITAL heart disease; STRESS echocardiography; CARDIAC surgery
- Publication
Journal of Interventional Cardiac Electrophysiology, 2018, Vol 52, Issue 2, p141
- ISSN
1383-875X
- Publication type
journal article
- DOI
10.1007/s10840-018-0352-0