Introduction:
Atrial
septal defect is the most common congenital heart lesion in adults, and
the surgical intervention of closure of the percutaneous atrial septal
defect are increasing recently. Implantation of the atrial septal device
may protect these patients from potential complications induced by ASD,
but in a later stage can predispose them to other complications. AF is
more common in patients with the occluder compared with the general
population.1 Radiofrequency ablation is recommended
for AF, especially for the drug-refractory symptomatic
AF.2 Safe and easy access to the left atrium through
the occlusion device is the basic and critical step for catheter
ablation, which
dissuades
electrophysiologists from performing ablation in patients showing an
alternation of septal anatomy or predisposed with a potential risk of
complications. Here we describe the successful interventional strategy
following a peripheral balloon created transseptal access for AF
ablation in the setting of a large-sized septal occlusion device
implantation.