Atrial shunt

[rothwell]

Apparently I now have a left to right atrial shunt following a catheter.ablationH as this happened to anyone else and what are the consequences as I am concerned.

[BobD Volunteer]

Since the catheter has to be passed through the septum dividing the two atria there will always be a risk of a hole remaining but these normally heal in short order. After my last ablation in 2019 they did an echocardiogram next morning to check it was closed.

[rothwell in reply to BobD]

Thanks Bob but my ablation was in November 2019. Recently I had a chest x-ray which revealed slight enlargement of the right ventricle which the nurse said could be caused by a lung problem or a hole in the heart. This rang a bell and when I looked up the copy of the letter sent to my GP in November 2020 it mentioned that I had a "left to right atrial shunt" i.e. a hole allowing extra blood to pass through. I am now assuming that the perforation made during the ablation did not heal as expected and has consequences but will pursue this further. I just wondered if this has happened to anyone else

[CDreamer in reply to rothwell]

About 20-25% of people have an ASD (Atrial Septum Defect) and don’t know about it and it never causes any problems. Mine was only discovered when I had my ablation so there was no need to puncture the septum to get to the right left atria. I had X-rays, scans and echocardiogram prior to the procedure and it didn’t show on any of the screenings. During the ablation the EP did what is called a bubble test to see if blood passed from left to right and it wasn’t so nothing was done. Had it proved positive then they would have called in a cardiologist and done a repair. If you had an ASD prior to the ablation they may well do nothing, if it isn’t causing symptoms.

Best wishes.

[Megams in reply to rothwell]

~I'm wondering if the letter to your GP implies there was an atrial shunt present in the first instance & never detected?

EP who did my PVI (Feb 2022) noted that my right sided anatomy was slightly unusual, an anterior & posterior p/v as opposed to usual superior & inferior vessels.

This came as news to me even though I have had an genetic ASD (atrial septal defect) repair in 1988 & surgeon then did not mention this finding at the time.

An echo (April 2022) demonstrated the puncture wound had healed

I hope you can find further answers you are seeking - please keep us posted.

[rothwell in reply to Megams]

Thank you for your replies. When I went for a routine follow up visit in November 2020 a year after my second ablation, the specialist nurse informed me about the hole whi h had been caused by the ablation and when I expressed concern he told me that it was nothing to worry about so that was that A few weeks ago I had a chest xray for another reason and my GP informed me that I had a slightly enlarged heart....this was new....and sent me for an echocardiogram which revealed this slight enlargement. As I said in my previous post the nurse who was doing the echocardiogram said this could be the result of a hole in the heart and this triggered my memory and made me look at the copy of the letter sent to my GP following the follow up visit in November 2020 and to quote "She has normal size right and left atria but there is a left to right interatrial shunt detected on colour doppler." My concern now is that this appears to be the cause of the heart enlargement and having looked it up, it can cause other problems. Obviously I now need to explore this further with the medical profession but posted it to see if anyone else had experienced this and what the consequences were. For me at the moment it is a worrying consequence of having had the ablation.

[Megams in reply to rothwell]

~Oh dear - that answers the question and I am so sorry to hear this. I was always under the impression that the puncture/hole heals. This places your situation in a different light - did the echo report indicate size of shunt?

I will be interested to know what will be suggested going forward for you.

In the meantime I send all my best wishes in the hope that a suitable solution can be found without more procedures.

[captainKFF in reply to rothwell]

Hello My advice is don’t worry unnecessarily and don’t lose any sleep over it, in my case over the years different echo technicians wrote so many different interpretations from dilations in the heart chambers to abnormal diastolic function and some pulmonary hypertension in the end my last echoes were completely normal and I learned that an echo is completely subjective and some technicians gratuitously comment, perhaps for your own peace of mind it’s best not to chase these findings especially that the doctors are not getting concerned.