| Autor: |
Karim, Abdur Rehman, Oussama M, Wazni, Amr F, Barakat, Walid I, Saliba, Shailee, Shah, Khaldoun G, Tarakji, John, Rickard, Mohamed, Bassiouny, Bryan, Baranowski, Patrick J, Tchou, Mandeep, Bhargava, Thomas J, Dresing, Thomas D, Callahan, Daniel J, Cantillon, Mina, Chung, Mohamed, Kanj, Samuel, Irefin, Bruce, Lindsay, Ayman A, Hussein |
| Rok vydání: |
2018 |
| Předmět: |
|
| Zdroj: |
JACC. Clinical electrophysiology. 5(3) |
| ISSN: |
2405-5018 |
| Popis: |
This study sought to assess the incidence and outcomes of life-threatening complications from atrial fibrillation ablations in a high volume center.With increasing rates of atrial fibrillation ablation procedures, an increase in life-threatening procedure-related complications has been reported despite improvements in technology and ablation strategies.Between 2000 and 2015, 10,378 patients underwent atrial fibrillation ablation at our institution and were enrolled in a prospectively maintained data registry. We identified all patients who had life-threatening cardiac, neurological, respiratory, or vascular complications to the ablation resulting in death or requiring emergent intervention.Major life-threatening complications occurred in 100 patients (0.9%). The most common was pericardial effusion requiring pericardiocentesis (0.5%), with 7 (0.07%) requiring emergent surgical repair for cardiac perforation. Stroke occurred in 27 patients (0.3%) with a vast majority having an ischemic stroke (93%) followed by hemorrhagic (3.5%) and ischemic stroke with hemorrhagic conversion (3.5%). The yearly incidence of stroke decreased from an average of 1.1% per year in the first tertile (2000 to 2004) to 0.2% per year in the last 2 tertiles (2005 to 2015). Permanent neurological deficits occurred in 23 patients. Vascular complications causing hemorrhagic shock occurred in 7 patients (0.06%), 5 of whom required urgent surgical intervention. Acute coronary syndrome requiring urgent percutaneous coronary revascularization occurred in 2 patients whereas 1 developed a right coronary artery air embolus. No procedural death or atrio-esophageal fistulae occurred.In a large quaternary care center, the incidence of life-threatening complications is low. Experienced operators, high volume, continuous quality improvement initiatives, and efficient back-up support have allowed exemplary safety profiles and 0 procedure-related deaths over 16 years. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
