Updated National Multicenter Registry on Procedural Safety of Catheter Ablation for Atrial Fibrillation

Abstract

Major complications occurred in 4.0% of the CA procedures for AF, with vascular access complications being the most frequent events.

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

“…252,289,290,291,806,808,920,1050,1051,1052,1053,1054,1056,1057,1058,1059 A multicenter U.S. retrospective study reported total complications of 3265 (518 in women vs 2747 in men), with a 5% complication rate in women vs 2.4% in men ( P <.001). This study found more hematomas and pseudoaneurysms in women.…”

Safety of Continuous Periprocedural Rivaroxaban for Patients Undergoing Left Atrial Catheter Ablation Procedures

“…23 In the multivariable regression analysis, female sex was associated with complications as also shown in other studies. 24,25 Persistent AF and atrial tachycardias as presenting rhythm represented a risk factor for complications, probably because of a more extensive ablation strategy and a more fibrotic LA.…”

Ablation of atrial fibrillation

“…U.S. registry data from over 93,000 patients in the U.S. national inpatient sample database 5 showed an in-hospital mortality rate of 0.42%, and an overall complication rate of 6.29% (figure 4) that were lower in high volume centers. The possibility that complication rates are trending higher in some studies 5 , although not others 107-110 , may reflect treatment of more complex, older patients with persistent AF 111 in whom widespread ablation and long procedure times may cause complications. This again argues for a more targeted, mechanistic approach to AF ablation.…”

“…eliminating PV stenosis by ablating widely outside PVs (figure 2B) instead of close to the thin-walled PVs, while better sheath management and anticoagulation can reduce thromboembolic risk. Accordingly, AF ablation procedural safety has increased with very low mortality in multicenter surveys 107, 108 and data from both the US 109 and Europe 110 . Data have consistently shown 107, 108 that procedural outcomes improve with center experience.…”