title: One Year Incidence of Atrial Septal Defect after PV Isolation: A Comparison Between Conventional Radiofrequency and Cryoballoon Ablation.
abstract: BACKGROUND
  Transseptal (TS) catheterization is needed to access the left heart during pulmonary vein isolation (PVI) procedures. In the radiofrequency (RF) ablation procedure, left atrial access is commonly achieved with a double TS puncture; cryoballoon (CB) ablation usually requires only a single TS puncture. Our aim was to compare the incidence of iatrogenic septal defect (IASD) between double transseptal conventional RF and CB ablation.
  
  
  RESULTS
  Individuals having undergone PVI as index procedure by RF or CB ablation and a subsequent transesophageal echocardiography examination during postablation follow-up in our center were consecutively included. A total of 127 patients formed the study group (92 males; mean age 60 ± 11 years). IASD was present in 17 patients (13.4%) after a mean follow-up time of 11.6 months. The incidence of IASD at 1-year follow-up following PVI was significantly higher in the CB ablation group compared with the RF ablation group (22.2% vs 8.5%; P = 0.03). Mean IASD diameter was larger in the CB group (0.60 cm × 0.50 cm vs 0.44 cm × 0.35 cm) without statistical significance. Only left to right atrial shunt was observed. No adverse events were recorded in these patients during the follow-up.
  
  
  CONCLUSIONS
  the incidence of IASD at 1-year follow-up following CB ablation procedure for PVI is significantly higher with respect to RF procedures. Although no adverse clinical events were recorded in patients with persistence of IASD, more detailed echocardiographic examinations might be advised in all individuals exhibiting this finding.
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Mugnai
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Juan
authors.initials: J
authors.lastname: Sieira
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciconte
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Marta Soriano
authors.initials: MS
authors.lastname: Hervas
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Ghazala
authors.initials: G
authors.lastname: Irfan
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saitoh
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Burak
authors.initials: B
authors.lastname: Hünük
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Erwin
authors.initials: E
authors.lastname: Ströker
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Vedran
authors.initials: V
authors.lastname: Velagic
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Kristel
authors.initials: K
authors.lastname: Wauters
authors.affiliation: Cardiac Arrhythmia Research Centre, Centro Cardiologico Monzino IRCCS, Milan, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Tondo
authors.affiliation: Department of Cardiology, Sacro Cuore Hospital, Negrar, Verona, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Molon
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Carlo
authors.initials: C
authors.lastname: De Asmundis
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D015984:Causality; D015897:Comorbidity; D003452:Cryosurgery / Q000706:statistics & numerical data*; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011667:Pulmonary Veins / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: atrial fibrillation; cryoballoon; iatrogenic septal defect; radiofrequency