Zeng Linwen, Xu Wuxu, Makota Panashe, Liao Xuewen, Wu Meiqiong, Peng Yiming, Chen Jianquan, Zhang Jiancheng
Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350013, China.
Department of Cardiology, Shengli Clinical Medicine College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fujian Provincial Hospital, No. 134 East Street, Gulou District, Fuzhou, Fujian, 350000, People's Republic of China.
Eur J Med Res. 2025 Jul 10;30(1):612. doi: 10.1186/s40001-025-02875-y.
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.
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.
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.
医源性房间隔缺损（IASD）可能发生在心房颤动（AF）患者的冷冻球囊消融术（CBA）之后。本研究旨在调查CBA术后IASD的发生率和愈合情况，并分析与IASD发生相关的危险因素及临床意义。
连续纳入2021年至2023年在福建省立医院接受CBA的非瓣膜性AF患者。然后根据术后3个月的经胸超声心动图将他们分为IASD组和非IASD组。在262例AF患者中，CBA术后12个月时IASD的发生率从29.0%降至9.7%。IASD组的左心房直径（LAD）更大，手术时间更长，高血压病史的比例高于非IASD组。多元线性回归（MLR）分析显示，术前LAD和高血压病史与IASD的发生独立相关。在随访期间，未观察到缺血性卒中、异位栓塞、短暂性脑缺血发作或其他不良事件。
CBA术后IASD的发生率相对较高，但一般倾向于自发愈合。术前LAD和高血压病史是术后IASD的独立危险因素。IASD的临床结局相对安全，未观察到严重的心脑血管不良事件。
