INTRODUCTION: Pulmonary vein isolation (PVI) is widely practiced for treating atrial fibrillation. Transseptal access is necessary with one or even more transseptal sheaths to perform PVI. METHODS: In this prospective study, 31 patients were examined with transesophageal echocardiography before, immediately after and in a 3-, 6- and 12-month follow-up period for evaluation of iatrogenic atrial septal defect (iASD). All patients underwent PVI with double transseptal puncture. RESULTS: An iASD was detected in 27/31 patients (87%) with a maximum diameter of 1.0 mm. After 3 months, the iASDs were completely closed in 26/27 (96.3%) patients. In 1/27 (3.7%) patients, there was an iASD detectable even after 12 months. Clinically no patient suffered from cerebral or cardiac embolism in the follow-up period. CONCLUSIONS: We were only able to find small iASDs with left to right shunting after PVI but none with right to left shunting. iASDs following PVI show a high spontaneous closure rate already at 3 months of follow-up and are not associated with an increased rate of paradoxical embolism.
INTRODUCTION: Pulmonary vein isolation (PVI) is widely practiced for treating atrial fibrillation. Transseptal access is necessary with one or even more transseptal sheaths to perform PVI. METHODS: In this prospective study, 31 patients were examined with transesophageal echocardiography before, immediately after and in a 3-, 6- and 12-month follow-up period for evaluation of iatrogenic atrial septal defect (iASD). All patients underwent PVI with double transseptal puncture. RESULTS: An iASD was detected in 27/31 patients (87%) with a maximum diameter of 1.0 mm. After 3 months, the iASDs were completely closed in 26/27 (96.3%) patients. In 1/27 (3.7%) patients, there was an iASD detectable even after 12 months. Clinically no patient suffered from cerebral or cardiac embolism in the follow-up period. CONCLUSIONS: We were only able to find small iASDs with left to right shunting after PVI but none with right to left shunting. iASDs following PVI show a high spontaneous closure rate already at 3 months of follow-up and are not associated with an increased rate of paradoxical embolism.
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Authors: Lars Lickfett; Matthias Hackenbroch; Thorsten Lewalter; Stephanie Selbach; Jörg O Schwab; Alexander Yang; Osman Balta; Jan Schrickel; Alexander Bitzen; Berndt Lüderitz; Torsten Sommer Journal: J Cardiovasc Electrophysiol Date: 2006-01
Authors: Roberto De Ponti; Riccardo Cappato; Antonio Curnis; Paolo Della Bella; Luigi Padeletti; Antonio Raviele; Massimo Santini; Jorge A Salerno-Uriarte Journal: J Am Coll Cardiol Date: 2006-02-09 Impact factor: 24.094
Authors: Giovanni B Forleo; Domenico G Della Rocca; Carlo Lavalle; Massimo Mantica; Lida P Papavasileiou; Valentina Ribatti; Germana Panattoni; Luca Santini; Andrea Natale; Luigi Di Biase Journal: J Atr Fibrillation Date: 2016-02-29