Original-clinicalEarly complications of pulmonary vein catheter ablation for atrial fibrillation: A multicenter prospective registry on procedural safety
Section snippets
Patients
Of the 32 Italian electrophysiology laboratories listed in the Italian Association of Arrhythmology and Cardiostimulation ablation procedures national Registry,10 10 agreed to participate in this prospective registry, which was set up in April 2005. Data collection was scheduled to last 18 months. The investigators included in the Registry all consecutive patients who were undergoing catheter ablation in their laboratories for every type of AF. Not all centers entered the Registry within the
Clinical and procedural data
Data from 1,011 consecutive patients were collected. Clinical data are shown in Table 1. Preablation transesophageal echocardiographic assessment was performed in 628 patients (62.1%), whereas 99 (9.8%) and 69 (6.8%) underwent preprocedural computed tomography or magnetic resonance imaging to define pulmonary vein anatomy. In 798 cases (78.9%) a 3-dimensional nonfluoroscopic mapping technique was used: the Carto system (Biosense Webster Inc., Diamond Bar, CA) in 650 patients (64.3%) and Navx
Main findings
This is the first multicenter study aimed at prospectively collecting data regarding the safety of pulmonary vein radiofrequency catheter ablation for AF in an unselected population of patients. We observed a cumulative complication rate of 3.9%, hemorrhagic complications (cardiac tamponade, pericardial effusion, 1.4%), peripheral vascular complications (1.2%), cerebral embolic events (0.5%), and pulmonary vein stenosis (0.4%) being the most frequent. Among several clinical and procedural
Conclusions
The increasing number of pulmonary vein ablation procedures for AF has allowed electrophysiologists to become aware of the peculiarities and potential dangers of these procedures. Major complications seem to be fewer than in the early years of AF ablation, but still occur in 3.9% of procedures, the most frequent being peripheral vascular problems, pericardial effusion, cardiac tamponade, cerebral embolism, and pulmonary vein stenosis.
References (22)
- et al.
A new approach for catheter ablation of atrial fibrillation: mapping of the electrophysiologic substrate
J Am Coll Cardiol
(2004) - et al.
Circumferential pulmonary vein ablation for chronic atrial fibrillation
N Engl J Med
(2006) - et al.
Radiofrequency ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial
JAMA
(2005) - et al.
Catheter ablation treatment in patients with drug-refractory atrial fibrillation: a prospective, multi-centre, randomized, controlled study (Catheter Ablation For the Cure of Atrial Fibrillation Study)
Eur Heart J
(2006) - et al.
Catheter ablation for atrial fibrillation
Heart
(2005) - et al.
Stepwise catheter ablation of chronic atrial fibrillation: importance of discrete anatomic sites for termination
J Cardiovasc Electrophysiol
(2006) - et al.
ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines
Circulation
(2006) - et al.
Phased-array intracardiac echocardiography monitoring during pulmonary vein isolation in patients with atrial fibrillationImpact on outcome and complications
Circulation
(2003) - et al.
Worldwide survey on methods, efficacy and safety of catheter ablation for human atrial fibrillation
Circulation
(2005) Registro ablazioni: attività dei laboratori italiani di elettrofisiologia nel 2002
G Ital Aritmol Cardiostim
(2003)
Venice Chart international consensus document on atrial fibrillation ablation
J Cardiovasc Electrophysiol
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