Arrhythmias & electrophysiologyCohort study
Clinical significance of persistent iatrogenic atrial septal defect after catheter ablation for atrial fibrillation
- retrospective study
- consecutive patients
- predefined subgroup
Authors' conclusion
Persistent iASD was associated with AF recurrence on unadjusted analysis, cardiovascular mortality, and early-phase HF hospitalization after AF ablation. These findings suggest that persistent iASD may serve as a clinically relevant marker of adverse prognosis after AF ablation.
Study context
- Population
- Patients who underwent first-time CA for atrial fibrillation (AF) at Ogaki Municipal Hospital from 2012 to 2022, with transthoracic echocardiography performed before and 3 months after ablationconsecutive patients, predefined subgroup of 578 patients (contact force-sensing radiofrequency ablation, standardized two-sheath approach) · overall cohort 1,288 · predefined subgroup 578
- Participants
- 1,288 patients
- Exposure
- Patients with persistent iatrogenic atrial septal defect (iASD) vs without, after AF ablation
- iASDn = 127
Main finding
As reported in the abstract
Higher with iASD on unadjusted analysis, overall cohort
P = .002
Higher with iASD on unadjusted analysis, predefined subgroup
P = .004
Observational data: associations, not effects.
Further findings
Independent predictors of persistent iASD
- sheath size and number, body size-related factors, and tricuspid regurgitation peak velocity
- multivariable analysis
Cardiovascular mortality
- Higher in patients with persistent iASD
- P = 0.02
Heart failure (HF) hospitalization
- Higher in patients with persistent iASD
- P < 0.001
- HF events clustering in the early phase (≤6 months)
Ischemic stroke
- Not higher in patients with persistent iASD
- P = 0.28
iASD detection · 3 months after ablation
- iASD detected
- 127 patients (9.9%)
Original publication
Summarised from the published abstract; every number is checked against it