Key result
Transseptal AF cryoablation is linked to higher risk and technical difficulty in patients with septal occluders.
Why the study?
Patients with atrial septal defects have higher risk of AF, but prior atrial septal occluder devices make mandatory transseptal puncture for catheter ablation more difficult and riskier.
Observational
Supports caution for transseptal cryoablation in atrial septal occluder patients; leaves open optimal techniques pending larger series.
Patients with atrial septal defects (ASD) seem to have higher risk of developing atrial arrhythmias and atrial fibrillation (AF).1–5 Over the past decade, AF catheter ablation has developed as an effective therapeutic approach.6,7 Transseptal access to the left atrium (LA) is mandatory for the ablation, and transseptal puncture (TSP) in patients with atrial septal occluder (ASO) devices is likely to be more frequent in the future. However, the ASO makes the TSP more difficult and riskier, which represents a major obstacle to the widespread adoption of catheter ablation in patients with prior ASD closure.
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Marinelli et al. (2024) conducted an observational in Atrial fibrillation in patients with atrial septal occluder devices. Cryoablation was evaluated. Cryoablation of atrial fibrillation requiring transseptal puncture in patients with atrial septal occluder devices is technically challenging and riskier.
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