Effectiveness of a strategy to reduce major vascular complications from catheter ablation of atrial fibrillation

Abhishek, Fnu; Heist, E. Kevin; Barrett, Conor D.; Danik, Stephan B.; Blendea, Dan; Correnti, Christina M.; Khan, Zaka U.; Ruskin, Jeremy N.; Mansour, Moussa

doi:10.1007/s10840-010-9539-8

Cited by 55 publications

(32 citation statements)

References 19 publications

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“…805 Anticoagulation, in turn, contributes to some of the most common complications of the procedure, including hemopericardium, pericardial tamponade, and vascular complications. 806,807,808 Therefore, attention must be paid to achieving the optimal safe level of anticoagulation throughout the process.…”

Section: Section 7: Technical Aspects Of Ablation To Maximize Safety mentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

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Section: Section 7: Technical Aspects Of Ablation To Maximize Safety mentioning

confidence: 99%

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Calkins,

Kuck,

Cappato

et al. 2012

Heart Rhythm

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1,762

1,468

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“…6,7) Different authors have varied definitions of cardiac effusion. The incidence of total cardiac effusion from asymptomatic to cardiac tamponade requiring surgery is 14.2% (19/133).…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac tamponade after RFCA is reported from 0.1% up to 6%. 5,6,8) Vascular complications occur in approximately 2% to 4% of procedures, including retroperitoneal bleeding, hematoma, vascular injury, transient ischemic attack and hypotension. Left atrial-esophageal fistula is an extremely fatal complication.…”

Section: Discussionmentioning

confidence: 99%

“…Left atrial-esophageal fistula is an extremely fatal complication. 6) Cardiac perforation requiring surgery is a rare but fatal complication in RFCA for atrial fibrillation, and the incidence of cardiac perforation requiring surgery is reported from 0.05% to 0.32%. 2,9) Until now, reports on the incidence and surgical repair of cardiac perforation have been scant.…”

Section: Discussionmentioning

confidence: 99%

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Multiple Cardiac Perforations Following Radiofrequency Catheter Ablation: Case Report and Literature Reviews

Liu

Ren

Qian

et al. 2012

ATCS

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Introduction: Multiple cardiac ruptures after radiofrequency catheter ablation that requires surgical repair are uncommon. Methods and Results: We describe a 64-year old male patient with paroxysmal atrial fibrillation who had a cardiac tamponade following radiofrequency ablation. Surgical exploration demonstrated two ruptures in the left atrium, one in the right atrium, and one hematoma in the right atrium. MEDLINE, the Cochrane Library, and related databases were searched up to June 2011 without language restrictions, and related literature was reviewed and discussed. The patient has survived from prompt cardiac repair of cardiac ruptures and recovered from surgery without complications. Conclusions: Urgent exploratory surgery with cardiopulmonary bypass is the key to salvage the patient.

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“…The need for a more efficient method of sheath introduction, requiring less force, provided the motivation to modify the existing method with the use of the techniques described and used earlier for other types of procedure [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

“Buddy wire” for facilitation of femoral venous access for cryoablation: a preliminary report

et al. 2017

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A b s t r a c tBackground: Some electrophysiological techniques, such as balloon cryoablation, involve the use of steerable sheaths of large diameter (outer diameter 15 Fr or more). Their introduction to the femoral vein may be difficult, especially in patients who have had numerous venipunctures in this area. Aim:The authors describe a modification of typical venous access with the use of a "buddy wire" technique, facilitating the insertion of the cryoablation sheaths to the femoral vein. Methods:A case-control study. The study involved a retrospective analysis of 27 consecutive procedures of balloon cryoablation of pulmonary veins performed in 2015 by the first author, compared to 23 consecutive procedures of balloon cryoablation performed in 2014 without a "buddy wire" technique. The study and control groups did not vary significantly. There were 11 women in both groups. The average age of the patients was 55.9 years. The "buddy wire" technique was the only difference in procedure performance between the control and study groups. In the study group a short introducer was inserted through a puncture of the right femoral vein, and then two wires were introduced through it. One of them was secured, so that it could not move, while the other served as a typical trans-septal puncture monitored with the use of X-ray. The standard trans-septal sheet was replaced with a 15 Fr steerable sheath, inserted through the same puncture site next to the secured "buddy wire". The short wire was then removed from the femoral vein. Typical balloon cryoablation of pulmonary veins was performed. After the end of the procedure, the puncture site was secured with a haemostatic suture for 12-18 h. Results:Femoral access with a 15 Fr steerable sheath and cryoablation were safely performed in all patients in the study group and in 22 out of 23 in the control group (100% vs. 95.6%, p = NS). Pulmonary vein isolation in one patient was performed using another technique. No damage to steerable sheaths was observed. There were no vascular complications requiring extended hospitalisation, blood transfusion, or surgical interventions in either group. The "door-to-door" time of the procedures ranged from 2 h 32 min on average in the study group to 2 h 43 min on average in the control group (p = NS). There was significant reduction in fluoroscopy time: 7 min 15 s on average from 11 min 25 s (p = 0.0009). Conclusions:The use of the "buddy wire" technique may lead to significant reduction in fluoroscopy time during cryoablation of pulmonary veins by facilitating the insertion of the steerable sheaths to the femoral vein.

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Effectiveness of a strategy to reduce major vascular complications from catheter ablation of atrial fibrillation

Cited by 55 publications

References 19 publications

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

2012 HRS/EHRA/ECAS Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation: Recommendations for Patient Selection, Procedural Techniques, Patient Management and Follow-up, Definitions, Endpoints, and Research Trial Design

Multiple Cardiac Perforations Following Radiofrequency Catheter Ablation: Case Report and Literature Reviews

“Buddy wire” for facilitation of femoral venous access for cryoablation: a preliminary report

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