| Objective: Iatrogenic atrial septal defect as a complication of atrial septal puncture has attracted more and more scholars' attention.The purpose of this study was to investigate the healing of iatrogenic atrial septal defect after radiofrequency ablation of atrial fibrillation,and to explore the factors that affect the healing of iatrogenic atrial septal defect.Methods: 47 patients who accepted the radiofrequency ablation with atrial fibrillation at the First Affiliated Hospital of Guangxi Medical University from October 2014 to October 2015 were collected.Collect the general information of the patients,the diameter of the left atrium,the thickness of the foramen ovale,the EF value,the puncture method,the TEE inspection report before,24-48 hours and 3 months after the operation.The changes of the size of atrial septal defect 24-48 hours and 3 months after operation were analyzed by the Wilcoxon rank sum test.The factors that affect the healing were analyzed by the Logistic regression.Results: There were 18 patients(38%)who had iatrogenic atrial insufficiencyat 3 months postoperatively.There were 4 patients who had not detected iatrogenic atherosclerosis after 24-48 hours postoperatively.The remaining 43 patients had a significant reduction in atrial septal defect [24-48 h(4.7 ± 2.6)mm vs 3 months(1.1 ± 1.5)mm,P <0.05],the healing rate was 58%.There were3 patients can detect a small slot between the valve of foramen ovale and septum secundum 24-48 h after the procedure by TEE(size 0.6 mm,1.7 mm,1.14 mm).Whether atrial septal defect healed was related to diameter of the left atrium(OR=1.199,P<0.05).Conclusions: Atrial fibrillation in the treatment of pulmonary vein isolation,the iASDs after a single-puncture,double-transsseptal approach showed 58% healing rate 3 month after the operating.The diameter of the left atrium had effect on the healing of the iatrogenic atrial septal defect. |
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