A patent foramen ovale (PFO) has been associated with cryptogenic stroke and migraine.
1,2 Closure of the PFO has been advocated by some to treat migraine if conventional therapy fails, but the real benefit remains unclear.
2 Today, an increasing number of cardiac interventions are done with transseptal puncture (TSP) of the interatrial septum. It is assumed that this puncture hole closes after the intervention. Most electrophysiologists use multiple sheaths through the septum to perform pulmonary vein isolation. Migraine has never been reported as a complication of this procedure,
3 but has been observed occasionally when TSP was used in conditions with a high right-sided pressure, creating a real right-to-left shunt.
4 Nowadays, we treat paroxysmal atrial fibrillation (PAF) with pulmonary vein isolation, using a cryothermal balloon, inserted through a single 15 Fr transseptal sheath.
5 …
