BackgroundIatrogenic　atrial　septal　defect　(IASD)　may　occur　after　cryoballoon　ablation　(CBA)　for　atrial　fibrillation　(AF)　patients.　This　study　aimed　to　investigate　the　incidence　and　healing　status　of　IASD　after　CBA,　and　to　analyze　the　risk　factors　and　clinical　significance　associated　with　the　occurrence　of　IASD.Methods　and　resultsPatients　with　non-valvular　AF　who　underwent　CBA　in　Fujian　Provincial　Hospital　from　2021　to　2023　were　continuously　enrolled.　Then　they　were　divided　into　IASD　and　non-IASD　groups　according　to　3-month　postoperative　transthoracic　echocardiography.　Among　the　262　AF　patients,　the　rate　of　IASD　presence　decreased　from　29.0　to　9.7%　in　12　months　after　CBA.　IASD　group　had　larger　left　atrial　diameters　(LAD),　longer　operation　duration,　and　a　higher　proportion　of　hypertension　history　than　the　non-IASD　group.　Multiple　Linear　Regression　(MLR)　analyses　showed　that　preoperative　LAD　and　history　of　hypertension　were　independently　associated　with　IASD　occurrence.　During　the　follow-up　period,　there　were　no　ischemic　strokes,　ectopic　embolisms,　transient　ischemic　attacks,　or　other　adverse　events　being　observed.ConclusionsThe　incidence　of　IASD　after　CBA　is　relatively　high,　but　it　generally　tends　to　heal　spontaneously.　Preoperative　LAD　and　history　of　hypertension　are　independent　risk　factors　for　postoperative　IASD.　The　clinical　outcome　of　IASD　is　relatively　safe　and　no　serious　cardiovascular　or　cerebrovascular　adverse　events　have　been　observed.