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

Abstract

Background: The clinical implications of pericardial effusion (PE) after catheter ablation for atrial fibrillation (AF) are not well understood. We evaluated the association between newly developed PE after pulmonary vein isolation (PVI) for paroxysmal AF and arrhythmic recurrence. Methods: From a prospective AF ablation registry, 184 patients (mean age 59 ± 10 years, 65% male) who underwent first-time PV isolation using a smart touch surround flow catheter (Biosense Webster, Diamond Bar, CA) were analyzed. Postablation transthoracic echocardiography (TTE) was performed within 1-3 days after ablation, and the occurrence of PE was assessed. Results: PE developed in 91 patients (49.5%), and most were of minimal severity (minimal, 93.4%; mild, 6.6%). Patients with PE had significantly lower body mass index and underwent cavotricuspid isthmus ablation more frequently. Early arrhythmic recurrence (EAR) (within 3 months) was observed in 28.8% of patients and was not different according to the PE development (PE [+]: 29.7% vs PE [−]: 28.0%; P = .80). During a median follow-up of 696 days, the cumulative rate of the late arrhythmic recurrence (LAR) (after 3 months) was 36.4%, and there was no difference between groups