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Jayasheel Eshcol, MD, Alan P. Wimmer, MD, FHRS 

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1 Hemodynamically significant iatrogenic atrial septal defects after cryoballoon ablation 
Jayasheel Eshcol, MD, Alan P. Wimmer, MD, FHRS  HeartRhythm Case Reports  Volume 5, Issue 1, Pages (January 2019) DOI: /j.hrcr Copyright © 2018 Heart Rhythm Society Terms and Conditions

2 Figure 1 Baseline transesophageal echocardiogram from case 1 demonstrates an intact interatrial septum by 2-dimensional (A, B), agitated saline (C), and color imaging (D). HeartRhythm Case Reports 2019 5, 17-21DOI: ( /j.hrcr ) Copyright © 2018 Heart Rhythm Society Terms and Conditions

3 Figure 2 Intraprocedural transesophageal echocardiogram from case 1 after cryoballoon ablation demonstrates a large iatrogenic septal defect with inadequate rims (A, B) and large left-to-right shunt by color imaging (C, D). HeartRhythm Case Reports 2019 5, 17-21DOI: ( /j.hrcr ) Copyright © 2018 Heart Rhythm Society Terms and Conditions

4 Figure 3 Follow-up transesophageal echocardiogram from case 2 (20 months after cryoballoon ablation) demonstrates a persistent iatrogenic atrial septal defect (A–C) and right ventricle enlargement (D). HeartRhythm Case Reports 2019 5, 17-21DOI: ( /j.hrcr ) Copyright © 2018 Heart Rhythm Society Terms and Conditions

5 Supplemental Figure (Case 2)
Baseline transesophageal echocardiogram from case 2 demonstrating an intact interatrial septum (A–C) and normal right ventricle size (D). HeartRhythm Case Reports 2019 5, 17-21DOI: ( /j.hrcr ) Copyright © 2018 Heart Rhythm Society Terms and Conditions

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