Complications of Catheter Ablation for Atrial Fibrillation: Incidence and Predictors

Abstract

Complication rates from AF ablation remain significant, despite improved techniques and increased awareness of procedural risks. Both advanced age and female gender predict major adverse events, suggesting careful consideration of the risk/benefit profile in these patients prior to ablation.

Catheter Ablation of Lone Atrial Fibrillation

“…For example, one study showed no significant difference between major complication rates of the AF ablation in three different age groups of patients, namely <65 years, [65][66][67][68][69][70][71][72][73][74] years and ≥75 years (1.6% vs. 1.7% vs. 2.9%, p=ns) [126]. On the contrary, the other two studies demonstrated strong association between the occurrence of complication and older age of >70 and ≥75 years [127,128]. These findings were recently confirmed by another group of authors who identified age as one of the independent predictors of severe non-fatal procedural complications and death (OR 1.04 [95% CI: 1.01 to 1.07]; p=0.0155) [129].…”

“…There is consistency of the data from several studies on the increased procedural risk in women [127,[130][131][132]]. An analysis of 517 AF ablation procedures showed that female gender was an independent predictor of major complications (OR 3.…”

“…For example, in a series of the first 100 consecutive AF procedures complication rate was 9.0% and in the following 541 procedures it was twice lower (4.3%) [127]. Fatal outcome.…”

EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication

“…167,455 Numerous studies have evaluated ablation outcomes in ageing patients (variously defined as .65 through to .80). 444,445,[456][457][458][459][460][461][462] Observational studies have consistently reported high multiple procedure success rates at 12 months of up to 80% in older patients. Conflicting data exist regarding outcomes in comparative studies with one study demonstrating a reduced success rate in patients over 65 years while another study showed similar efficacy in patients over the age of 80 years to the younger cohort.…”

“…Conflicting data exist regarding outcomes in comparative studies with one study demonstrating a reduced success rate in patients over 65 years while another study showed similar efficacy in patients over the age of 80 years to the younger cohort. 461,463 Hypertension Hypertension is another well-recognized risk factor for development of atrial fibrillation. Mapping studies have demonstrated the presence of a more advanced atrial substrate in hypertensive patients compared with controls.…”