PURPOSE: Access-related neuropathy after atrial fibrillation (AF) ablation is underappreciated. We intend to describe the incidence, management, and prognosis of postprocedural neuropathy after AF ablation. METHODS: We performed a retrospective analysis of all consecutive patients with postprocedural neuropathy who underwent AF ablation in three high-volume tertiary care hospitals between January 2007 and April 2011. RESULTS: Of the 3,128 patients who underwent AF ablation during the study period, 25 (0.8 %) patients had postprocedural neuropathy and were included in the current study. Mean age was 58.5 ± 11.5 years with 18 (72 %) being males and 14 (56 %) having paroxysmal AF. Ulnar nerve, lateral femoral cutaneous nerve manifesting as meralgia paresthetica, and femoral nerve were involved in 5 (20 %), 13 (54 %), and 7 (26 %) of the patients, respectively. Majority of neuropathies were associated with periprocedural hematomas (19, 76 %), and a quarter (19/72, 26 %) of all hematomas were associated with neuropathy. Initial treatment included warm and cold compresses followed by nonsteroidal anti-inflammatory and narcotic pain medications. In addition to the above regimen, in some patients (11, 44 %), oral gabapentin was used and it was associated with a shorter time to symptom resolution (9.4 vs. 14.1 days, p = 0.007). All patients were symptom free within 90 days of the procedure. CONCLUSION: Postprocedural neuropathy after AF ablation is rare and is frequently associated with a periprocedural hematoma. Patients typically become symptom free within 90 days of the procedure, and gabapentin may have a role in earlier symptom resolution.
PURPOSE: Access-related neuropathy after atrial fibrillation (AF) ablation is underappreciated. We intend to describe the incidence, management, and prognosis of postprocedural neuropathy after AF ablation. METHODS: We performed a retrospective analysis of all consecutive patients with postprocedural neuropathy who underwent AF ablation in three high-volume tertiary care hospitals between January 2007 and April 2011. RESULTS: Of the 3,128 patients who underwent AF ablation during the study period, 25 (0.8 %) patients had postprocedural neuropathy and were included in the current study. Mean age was 58.5 ± 11.5 years with 18 (72 %) being males and 14 (56 %) having paroxysmal AF. Ulnar nerve, lateral femoral cutaneous nerve manifesting as meralgia paresthetica, and femoral nerve were involved in 5 (20 %), 13 (54 %), and 7 (26 %) of the patients, respectively. Majority of neuropathies were associated with periprocedural hematomas (19, 76 %), and a quarter (19/72, 26 %) of all hematomas were associated with neuropathy. Initial treatment included warm and cold compresses followed by nonsteroidal anti-inflammatory and narcotic pain medications. In addition to the above regimen, in some patients (11, 44 %), oral gabapentin was used and it was associated with a shorter time to symptom resolution (9.4 vs. 14.1 days, p = 0.007). All patients were symptom free within 90 days of the procedure. CONCLUSION: Postprocedural neuropathy after AF ablation is rare and is frequently associated with a periprocedural hematoma. Patients typically become symptom free within 90 days of the procedure, and gabapentin may have a role in earlier symptom resolution.
Authors: Oussama M Wazni; Nassir F Marrouche; David O Martin; Atul Verma; Mandeep Bhargava; Walid Saliba; Dianna Bash; Robert Schweikert; Johannes Brachmann; Jens Gunther; Klaus Gutleben; Ennio Pisano; Dominico Potenza; Raffaele Fanelli; Antonio Raviele; Sakis Themistoclakis; Antonio Rossillo; Aldo Bonso; Andrea Natale Journal: JAMA Date: 2005-06-01 Impact factor: 56.272
Authors: Nassir F Marrouche; David O Martin; Oussama Wazni; A Marc Gillinov; Allan Klein; Mandeep Bhargava; Eduardo Saad; Dianna Bash; Hirotsugu Yamada; Wael Jaber; Robert Schweikert; Patrick Tchou; Ahmad Abdul-Karim; Walid Saliba; Andrea Natale Journal: Circulation Date: 2003-05-19 Impact factor: 29.690
Authors: Umashankar Lakshmanadoss; Wai Shun Wong; Ilana Kutinsky; M Rizwan Khalid; Brian Williamson; David E Haines Journal: Indian Pacing Electrophysiol J Date: 2017-02-20