Key result
Sequential cryoballoon pulmonary vein isolation and left atrial appendage occlusion prior to atrial septal defect closure was performed safely, with no thrombi or leakage at 3 months.
Why the study?
In patients with both AF and ASD, sequential cryoballoon PVI, LAA occlusion, and ASD closure could represent a strategy to prevent stroke and right heart failure.
Can sequential cryoballoon PVI and LAA occlusion prior to ASD closure be performed safely in AF patients with ASD?
Case Report (n=1)
No
Can sequential cryoballoon PVI and LAA occlusion prior to ASD closure be performed safely in AF patients with ASD?
Sequential cryoballoon PVI and LAA occlusion prior to ASD closure appears safe and feasible in a patient with AF and ASD.
BACKGROUND: In patients who suffer from both atrial fibrillation (AF) and atrial septal defect (ASD), cryoballoon pulmonary vein isolation (PVI), sequential left atrial appendage (LAA) occlusion and ASD closure could be a strategy for effective prevention of stroke and right heart failure. CASE SUMMARY: A 65-year-old man was admitted to our institution due to recurrent episodes of palpitations and shortness of breath for 2 years, which had been worsening over the last 48 h. He had a history of AF, ASD, coronary heart disease with stent implantation and diabetes. Physical and laboratory examinations showed no abnormalities. The score of CHA2DS2VASc was 3, and HAS-BLED was 1. Echocardiography revealed a 25-mm secundum ASD. Pulmonary vein (PV) and LAA anatomy were assessed by cardiac computed tomography. PV mapping with 10-pole Lasso catheter was performed following ablation of all four PVs with complete PVI. Following the cryoballoon PVI, the patient underwent LAA occlusion under transesophageal echocardiographic monitoring. Lastly, a 34-mm JIYI ASD occlude device was implanted. A follow-up transesophageal echocardiography at 3 mo showed proper position of both devices and neither thrombi nor leakage was found. CONCLUSION: Sequential cryoballoon PVI and LAA occlusion prior to ASD closure can be performed safely in AF patients with ASD.
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Wu et al. (2022) conducted a case report in Atrial fibrillation and atrial septal defect (n=1). Sequential cryoballoon PVI, LAA occlusion, and ASD closure was evaluated on Device position, thrombi, and leakage at 3 months. Sequential cryoballoon pulmonary vein isolation and left atrial appendage occlusion prior to atrial septal defect closure was performed safely, with no thrombi or leakage at 3 months.
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