Persistence of Atrial Septal Defect After Cryoballoon Ablation of Atrial Fibrillation

J Am Coll Cardiol: 10/1/13

Persistent iatrogenic atrial septal defect (iASD) after transseptal puncture for radiofrequency (RF) ablation of atrial fibrillation (AF) using 8-F sheaths has been reported at rates of 0 to 19% at medium-term follow-up, depending on the transseptal puncture technique, the follow-up interval, and whether transthoracic echocardiography (TTE) or transesophageal echocardiography was used for assessment 1. Cryoballoon ablation is an emerging technology for the treatment of patients with AF that uses a 12-F inner diameter (15-F outer diameter) sheath (FlexCath, Medtronic, Minneapolis, Minnesota). The effect of this larger sheath size is poorly described; a single study using transesophageal follow-up in only 13 patients (without a comparison group) reported residual iASD in 38% at 6 months and 31% at 9 months (2). We aimed to assess the prevalence of persistent iASD in a larger group undergoing cryoballoon ablation of AF compared with RF ablation. Read More