A comparative study of pericardial effusion and pleural effusion after cryoballoon ablation or radiofrequency catheter ablation of atrial fibrillation

Abstract

Introduction: The incidence and clinical outcome of pericardial and pleural effusion after cryoballoon ablation (CBA) or radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) have not been fully investigated.Methods: A total of 60 patients with paroxysmal AF were treated with either CBA (n = 30) or RFCA (n = 30) groups, with assessment of serum troponin I level, left atrial pulmonary vein computed tomography (CT) angiography and echocardiography within 24 hours before ablation, and serum troponin I level at 12 hours, and chest CT and echocardiography within 24 hours postablation. Repeat chest CT was performed 1 month after the index procedure in patients with pericardial or pleural effusion.Results: With similarly distributed baseline characteristics, the CBA group relative to the RFCA group had postablation: higher serum troponin I level (13.48 vs 1.84 µg/L, P < .001); similarly high pericardial effusion rates on chest CT (80% vs 93.3%, P > .05), with chest CT yielding significantly higher detection rate than echocardiography; similarly high pleural effusion rates on chest CT (73.3% vs 80%, P > .05); and smaller maximum depths on chest CT cross-section of pericardial effusion (5.21 ± 3.37 vs 7.13 ± 2.68 mm, P < .05) and pleural effusion bilaterally (left: 4.16 ± 4.90 vs 6.96 ± 5.42 mm; right: 5.04 ± 4.46 vs 7.55 ± 4.95 mm, both P < .05). The effusions selfresolved within a mean period of 1 month.Conclusions: Both CBA and RFCA were associated with high rates of pericardial and pleural effusion, with RFCA yielding numerically higher incidence and significantly higher effusion extent, and chest CT significantly higher detection rates than echocardiography. K E Y W O R D S atrial fibrillation, catheter ablation, pericardial effusion, pleural effusion

Association of pericardial effusion after pulmonary vein isolation and outcomes in patients with paroxysmal atrial fibrillation

“…In our analysis, postablation troponin I levels were not different according to PE severity. Others have reported that the postablation elevation of cardiac enzymes was not correlated with postablation PE 15 or the magnitude of inflammatory marker elevation 16 . Therefore, the inflammatory response and myocardial damage may be important factors in the development of new PE after AF ablation.…”

Direct Comparison Between Second-Generation Cryoballoon Ablation Versus Contact Force-Sensing Radiofrequency Ablation in Paroxysmal Atrial Fibrillation Patients: A Systematic Review and Meta-Analysis Study

“…Of the initial 752 collected articles, 12 studies were eligible to be included in this systematic review and meta-analysis [39][40][41][42][43][44][45][46][47][48][49][50]. The owchart describing the study selection process is demonstrated in Figure 1.…”

“…Our current systematic review and meta-analysis study including one multicenter RCT [39], two single-center RCTs [40,48], six single-center cohort studies [41][42][43][44]47,50], and three multicenter cohort studies [45,46,49]. The Electroanatomical mapping was conducted using CARTO 3 in nine studies [39][40][41][42][43][44][45]48,49].…”

“…While in three studies, the electroanatomical mapping was performed using CARTO 3 or EnSite [46,47,50]. Cryoballoon ablation procedures were conducted using the 28-mm 2G-CB catheter in almost all studies [39][40][41][42][43][44][45][47][48][49][50] Only study from Squara et al that used the 23 or 28-mm 2G-CB catheter [46]. Cryoballoon ablation procedures were conducted 1 to 2 times for each pulmonary vein, with the duration ranged from 180 to 240 seconds.…”

“…Radiofrequency ablation procedures were conducted using the CF-RF catheter [39][40][41][42][43][44][45][46][47][48][49][50]. In most studies, the pulmonary veins were isolated using the lowpower and/or long-duration radiofrequency ablation approach [40][41][42][43][44][46][47][48][49][50]. Most of the studies had the 3-month blanking period [40][41][42][43][44][45]47,49,50].…”