title: One year incidence of iatrogenic atrial septal defect after cryoballoon ablation for atrial fibrillation.
abstract: BACKGROUND
  Pulmonary vein (PV) isolation by means of cryoballoon (CB) technology is an effective treatment for symptomatic paroxysmal atrial fibrillation (AF) refractory to antiarrhythmic drug therapy. The CB requires a 15F transseptal sheath that may lead to the creation of a iatrogenic atrial septal defect (IASD).
  
  
  RESULTS
  Individuals having undergone PV isolation by the means of CB ablation and a subsequent transesophageal echocardiography (TEE) examination during postablation follow-up were consecutively included. Thirty-nine patients formed the study group (31 male, 76.9%; mean age 57.4 ± 13.7 years). IASD was present in 8 (20%) of them after a mean follow-up time of 11.7 months. Mean diameter of the defect was 0.57 cm × 0.48 cm; only left to right shunt was observed. No adverse events were recorded in these patients during the follow-up.
  
  
  CONCLUSIONS
  IASD after CB ablation of AF is present in up to 20% of patients after 1 year. Although no adverse clinical events were recorded in patients with persistence of IASD, this complication should not be underestimated and systematic echocardiographic examinations might be advised at regular intervals in the follow-up period after CB. Further studies with larger population and follow-up might be required to confirm our findings.
authors.affiliation: Heart Rhythm Management Center, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Juan
authors.initials: J
authors.lastname: Sieira
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.forename: Giacomo
authors.initials: G
authors.lastname: Di Giovanni
authors.forename: Giulio
authors.initials: G
authors.lastname: Conte
authors.forename: Carlo
authors.initials: C
authors.lastname: De Asmundis
authors.forename: Andrea
authors.initials: A
authors.lastname: Sarkozy
authors.forename: Steven
authors.initials: S
authors.lastname: Droogmans
authors.forename: Giannis
authors.initials: G
authors.lastname: Baltogiannis
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saitoh
authors.forename: Giusepe
authors.initials: G
authors.lastname: Ciconte
authors.forename: Moises
authors.initials: M
authors.lastname: Levinstein
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000601:surgery*; D003452:Cryosurgery / Q000009:adverse effects* / Q000639:trends; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D013997:Time Factors; D016896:Treatment Outcome
keywords: atrial fibrillation; cryoballoon; iatrogenic septal defect