Premium
One Year Incidence of Atrial Septal Defect after PV Isolation: A Comparison Between Conventional Radiofrequency and Cryoballoon Ablation
Author(s) -
MUGNAI GIACOMO,
SIEIRA JUAN,
CICONTE GIUSEPPE,
HERVAS MARTA SORIANO,
IRFAN GHAZALA,
SAITOH YUKIO,
HÜNÜK BURAK,
Ströker ERWIN,
VELAGIC VEDRAN,
WAUTERS KRISTEL,
TONDO CLAUDIO,
MOLON GIULIO,
ASMUNDIS CARLO DE,
BRUGADA PEDRO,
CHIERCHIA GIANBATTISTA
Publication year - 2015
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12663
Subject(s) - medicine , ablation , incidence (geometry) , cardiology , pulmonary vein , radiofrequency ablation , atrial fibrillation , catheter ablation , surgery , physics , optics
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. Methods and 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.