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Erschienen in: Heart and Vessels 8/2022

21.02.2022 | Original Article

Iatrogenic atrial septal defect after HotBalloon ablation of atrial fibrillation

verfasst von: Yoshinori Nakamura, Hiroshi Sohara, Minoru Ihara

Erschienen in: Heart and Vessels | Ausgabe 8/2022

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Abstract

HotBalloon-based pulmonary vein isolation (HBPVI) has yielded encouraging clinical results in the treatment of atrial fibrillation (AF). Balloon ablation requires a larger sheath, which raises the concern for a persistent iatrogenic atrial septal defect (iASD). The present study aimed to investigate the incidence, clinical features, and the predictive factors of transthoracic echocardiography (TTE)-detectable iASD after HBPVI. All patients who underwent HBPVI of AF with pre- and post-ablation TTE were retrospectively analyzed. A 17-French steerable deflectable guiding sheath was inserted into the left atrium (LA) after a transseptal puncture, and an 8-French sheath was inserted via a single transseptal hole. In a total of 190 patients, 98 (52%) paroxysmal AF (PAF) and 92 (48%) non-PAF, the iASD was detected in 18 (9.4%) with a mean follow-up period of 12.7 ± 2.5 months after HBPVI. All patients had no clinical symptoms related to iASD. No embolic or heart failure events occurred. In the multivariate analysis, LA volume index and LA procedure time were identified as significant independent predictors of iASD. After HBPVI, TTE-detectable iASD was found in 9.4% of study patients. Larger LA size and longer LA procedure time were predictive factors for the persistence of iASD. All patients with iASD had no clinical symptoms 12 months after HBPVI; however, long-term follow-up may be necessary.
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Metadaten
Titel
Iatrogenic atrial septal defect after HotBalloon ablation of atrial fibrillation
verfasst von
Yoshinori Nakamura
Hiroshi Sohara
Minoru Ihara
Publikationsdatum
21.02.2022
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 8/2022
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-022-02039-6

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