Document Detail

Persistent iatrogenic atrial septal defect after a single-puncture, double-transseptal approach for pulmonary vein isolation using a remote robotic navigation system: results from a prospective study.
MedLine Citation:
PMID:  20080903     Owner:  NLM     Status:  MEDLINE    
AIMS: Persistent iatrogenic atrial septal defect (iASD) after transseptal puncture for pulmonary vein isolation (PVI) has been described recently as a complication of PVI. No data exists evaluating systematically the incidence and clinical implications of iASDs after PVI using a remote robotic navigation system (RNS) with sheaths with a distinct larger outer diameter. METHODS AND RESULTS: In this prospective study, 40 patients with either paroxysmal (n = 22, 55%) or persistent symptomatic atrial fibrillation were treated with circumferential PVI using an RNS. In all patients, a single-puncture, double-transseptal approach was used to access the left atrium. Transoesophageal echocardiography was performed before and the day after PVI as well as after a 3 and 6 months follow-up (FU). The day after ablation an iASD was detected in 38 of 40 (95%) patients with a mean diameter of 3.45 +/- 1.5 mm. At 6-month FU, the iASDs were closed in 30 of 39 (78.9%) patients. During the 6-month FU period, no patient died or suffered from cerebral or cardiac embolism. CONCLUSION: After a single-puncture, double-transseptal approach for PVI using the RNS, iASDs show a high spontaneous closure rate of 78.9% after a 6-month FU period. Persistent iASDs following PVI with the RNS are not associated with an increased rate of paradoxical embolism or with relevant shunting.
Andreas Rillig; Udo Meyerfeldt; Markus Kunze; Ralf Birkemeyer; Tomislav Miljak; Sebastian J?ckle; Bajram Hajredini; Fabian Treusch; Werner Jung
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-01-15
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  12     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-22     Completed Date:  2010-05-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  331-6     Citation Subset:  IM    
Department of Cardiology, Schwarzwald-Baar-Klinikum Villingen-Schwenningen, Academic Hospital of the University of Freiburg V?hrenbacherstr, 23, Villingen-Schwenningen, Germany.
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MeSH Terms
Atrial Fibrillation / epidemiology*,  surgery*
Catheter Ablation* / adverse effects,  methods,  statistics & numerical data
Follow-Up Studies
Heart Septal Defects, Atrial / epidemiology,  etiology*,  ultrasonography
Iatrogenic Disease* / epidemiology
Middle Aged
Multivariate Analysis
Postoperative Complications / epidemiology,  etiology*,  ultrasonography
Prospective Studies
Pulmonary Veins / surgery
Surgery, Computer-Assisted / instrumentation,  statistics & numerical data
Treatment Outcome
Comment In:
Europace. 2010 Mar;12(3):301-2   [PMID:  20173205 ]

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