Document Detail

Persistent iatrogenic atrial septal defect after pulmonary vein isolation : incidence and clinical implications.
MedLine Citation:
PMID:  18461430     Owner:  NLM     Status:  MEDLINE    
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.
Andreas Rillig; Udo Meyerfeldt; Ralf Birkemeyer; Fabian Treusch; Markus Kunze; Werner Jung
Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2008-05-07
Journal Detail:
Title:  Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing     Volume:  22     ISSN:  1383-875X     ISO Abbreviation:  J Interv Card Electrophysiol     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-07-24     Completed Date:  2008-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708966     Medline TA:  J Interv Card Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  177-81     Citation Subset:  IM    
Department of Cardiology, Academic Hospital of the University of Freiburg, Freiburg, Germany.
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MeSH Terms
Atrial Fibrillation / complications,  surgery*
Catheter Ablation / adverse effects*
Chronic Disease
Heart Septal Defects, Atrial / complications*,  diagnosis*
Middle Aged
Pulmonary Veins / surgery*

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