Analysis of healing status and influencing factors of iatrogenic atrial septal defect in patients with atrial fibrillation after cryoballoon ablation.

Abstract

Background: Iatrogenic atrial septal defect (IASD) may occur after cryoballoon ablation (CBA) for atrial fibrillation (AF) patients. This study aimed to investigate the incidence and healing status of IASD after CBA, and to analyze the risk factors and clinical significance associated with the occurrence of IASD.

Methods and results: Patients with non-valvular AF who underwent CBA in Fujian Provincial Hospital from 2021 to 2023 were continuously enrolled. Then they were divided into IASD and non-IASD groups according to 3-month postoperative transthoracic echocardiography. Among the 262 AF patients, the rate of IASD presence decreased from 29.0 to 9.7% in 12 months after CBA. IASD group had larger left atrial diameters (LAD), longer operation duration, and a higher proportion of hypertension history than the non-IASD group. Multiple Linear Regression (MLR) analyses showed that preoperative LAD and history of hypertension were independently associated with IASD occurrence. During the follow-up period, there were no ischemic strokes, ectopic embolisms, transient ischemic attacks, or other adverse events being observed.

Conclusions: The incidence of IASD after CBA is relatively high, but it generally tends to heal spontaneously. Preoperative LAD and history of hypertension are independent risk factors for postoperative IASD. The clinical outcome of IASD is relatively safe and no serious cardiovascular or cerebrovascular adverse events have been observed.