Echocardiography evaluation of iatrogenic atrial septal defect after combined procedure of catheter ablation and left atrial appendage closure for atrial fibrillation
Abstract Using transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) to investigate the occurrence and related causes of iatrogenic atrial septal defect (iASD) after catheter ablation combined with left atrial appendage closure (LAAC) for atrial fibrillation (AF) and its im...
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-025-86657-w |
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| author | Yu Xin Su Sai Nan Li Nan Nan Liu Ming Liang Zu Lu Wang Ping Zhang Qi Zhang Wei Wei Zhou |
| author_facet | Yu Xin Su Sai Nan Li Nan Nan Liu Ming Liang Zu Lu Wang Ping Zhang Qi Zhang Wei Wei Zhou |
| author_sort | Yu Xin Su |
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| description | Abstract Using transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) to investigate the occurrence and related causes of iatrogenic atrial septal defect (iASD) after catheter ablation combined with left atrial appendage closure (LAAC) for atrial fibrillation (AF) and its impact on the right heart system. We retrospectively analyzed 330 patients that underwent combined procedure of catheter ablation for AF and LAAC at General Hospital of Northern Theater Command from January 2018 to March 2022. These patients were divided into iASD group and non-iASD group according to whether there was persistent iASD shown on TEE at 3 months after procedure. There were 96 (29.1%) patients with iASD and 234 patients without in the TEE follow up at 3 months post-operation. Patients with iASD had larger left atrial volumes (76.5 ± 35.2 ml vs. 61.1 ± 21.9 ml, p = 0.036) as well as higher occurrence of mitral regurgitation (MR) (32.3% vs. 12.8%, p = 0.018) and tricuspid regurgitation (TR) (27.1% vs. 7.3%, p = 0.002). Procedural features showed that patients with persistent iASD had longer procedure time (92.1 ± 36.3 vs. 69.1 ± 17.8 min, p = 0.003) and larger sheath sizes (4.1 ± 1.2 mm vs. 3.3 ± 1.2 mm, p = 0.022). The preoperative and postoperative right heart parameters of patients in the persistent iASD group were compared, and there were no significant differences on right atrial/ventricular diameter, right heart systolic/diastolic function and pulmonary artery pressure (P > 0.05). The occurrence of iASD 3 months after combined atrial fibrillation ablation and LAAC was 29.1%. The size of left atrium, the pressure of left atrium, the manipulation time within left atrium, the size of sheath, and the use of ICE during operation was related to the closure of iASD. |
| format | Article |
| id | doaj-art-381f792ce9374e00bdd17c34a8e97838 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-381f792ce9374e00bdd17c34a8e978382025-01-26T12:24:45ZengNature PortfolioScientific Reports2045-23222025-01-011511810.1038/s41598-025-86657-wEchocardiography evaluation of iatrogenic atrial septal defect after combined procedure of catheter ablation and left atrial appendage closure for atrial fibrillationYu Xin Su0Sai Nan Li1Nan Nan Liu2Ming Liang3Zu Lu Wang4Ping Zhang5Qi Zhang6Wei Wei Zhou7Cardiovascular Research Institute, General Hospital of Northern Theater CommandCardiovascular Research Institute, General Hospital of Northern Theater CommandCardiovascular Research Institute, General Hospital of Northern Theater CommandCardiovascular Research Institute, General Hospital of Northern Theater CommandCardiovascular Research Institute, General Hospital of Northern Theater CommandCardiovascular Research Institute, General Hospital of Northern Theater CommandCardiovascular Research Institute, General Hospital of Northern Theater CommandCardiovascular Research Institute, General Hospital of Northern Theater CommandAbstract Using transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) to investigate the occurrence and related causes of iatrogenic atrial septal defect (iASD) after catheter ablation combined with left atrial appendage closure (LAAC) for atrial fibrillation (AF) and its impact on the right heart system. We retrospectively analyzed 330 patients that underwent combined procedure of catheter ablation for AF and LAAC at General Hospital of Northern Theater Command from January 2018 to March 2022. These patients were divided into iASD group and non-iASD group according to whether there was persistent iASD shown on TEE at 3 months after procedure. There were 96 (29.1%) patients with iASD and 234 patients without in the TEE follow up at 3 months post-operation. Patients with iASD had larger left atrial volumes (76.5 ± 35.2 ml vs. 61.1 ± 21.9 ml, p = 0.036) as well as higher occurrence of mitral regurgitation (MR) (32.3% vs. 12.8%, p = 0.018) and tricuspid regurgitation (TR) (27.1% vs. 7.3%, p = 0.002). Procedural features showed that patients with persistent iASD had longer procedure time (92.1 ± 36.3 vs. 69.1 ± 17.8 min, p = 0.003) and larger sheath sizes (4.1 ± 1.2 mm vs. 3.3 ± 1.2 mm, p = 0.022). The preoperative and postoperative right heart parameters of patients in the persistent iASD group were compared, and there were no significant differences on right atrial/ventricular diameter, right heart systolic/diastolic function and pulmonary artery pressure (P > 0.05). The occurrence of iASD 3 months after combined atrial fibrillation ablation and LAAC was 29.1%. The size of left atrium, the pressure of left atrium, the manipulation time within left atrium, the size of sheath, and the use of ICE during operation was related to the closure of iASD.https://doi.org/10.1038/s41598-025-86657-wIatrogenic atrial septal defectTransesophageal echocardiographyAtrial fibrillationLeft atrial appendage closureCatheter ablation |
| spellingShingle | Yu Xin Su Sai Nan Li Nan Nan Liu Ming Liang Zu Lu Wang Ping Zhang Qi Zhang Wei Wei Zhou Echocardiography evaluation of iatrogenic atrial septal defect after combined procedure of catheter ablation and left atrial appendage closure for atrial fibrillation Scientific Reports Iatrogenic atrial septal defect Transesophageal echocardiography Atrial fibrillation Left atrial appendage closure Catheter ablation |
| title | Echocardiography evaluation of iatrogenic atrial septal defect after combined procedure of catheter ablation and left atrial appendage closure for atrial fibrillation |
| title_full | Echocardiography evaluation of iatrogenic atrial septal defect after combined procedure of catheter ablation and left atrial appendage closure for atrial fibrillation |
| title_fullStr | Echocardiography evaluation of iatrogenic atrial septal defect after combined procedure of catheter ablation and left atrial appendage closure for atrial fibrillation |
| title_full_unstemmed | Echocardiography evaluation of iatrogenic atrial septal defect after combined procedure of catheter ablation and left atrial appendage closure for atrial fibrillation |
| title_short | Echocardiography evaluation of iatrogenic atrial septal defect after combined procedure of catheter ablation and left atrial appendage closure for atrial fibrillation |
| title_sort | echocardiography evaluation of iatrogenic atrial septal defect after combined procedure of catheter ablation and left atrial appendage closure for atrial fibrillation |
| topic | Iatrogenic atrial septal defect Transesophageal echocardiography Atrial fibrillation Left atrial appendage closure Catheter ablation |
| url | https://doi.org/10.1038/s41598-025-86657-w |
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