Aims: Complications from catheter ablation for atrial fibrillation (AF) are well described. Changing aspects of AF ablation including patient populations referred, institutional experience, and emerging catheter and pharmacological options may impact complication rates. We assessed procedural complication trends in AF ablation patients from 2003–2015 to identify what factors affect adverse event rates. Methods and Results: We evaluated consecutively enrolled patients undergoing initial AF ablation from 2003 through 2015. Statistical analyses were performed to identify predictors of increased risk for major complications, which were defined as death, stroke, atrio-oesophageal fistula, phrenic nerve injury, cardiovascular events requiring blood transfusions or procedural interventions, or non-cardiovascular events requiring intervention. A total of 1475 patients (mean age 59.5 ± 10.5, 82% male) were evaluated. Major complications occurred in 3.9% (n = 58) of cases, including vascular access-site haematoma (1.3%), cardiac tamponade (1.1%), and cerebrovascular accident (CVA) (0.9%). Univariate analysis revealed increased risk of complications associated with hypertension (P = 0.048), CHA2DS2VASc score ≥1 (P = 0.015), and early institutional experience (P = 0.003). Populations with higher CHA2DS2VASc scores underwent AF ablation more frequently over time (P < 0.001). Novel catheters and anticoagulants did not appreciably affect complication rates. Multivariate analysis adjusting for hypertension, CHA2DS2VASc score, and institutional experience showed that higher CHA2DS2VASc score and early institutional experience were independent predictors of adverse events. Conclusion: Patient characteristics reflected in CHA2DS2VASc scoring and early institutional experience predict increased complication rates following AF ablation. Despite more patients with higher CHA2DS2VASc scores undergoing AF ablation, complication rates fell over time as institutional experience increased.
Aims: Complications from catheter ablation for atrial fibrillation (AF) are well described. Changing aspects of AF ablation including patient populations referred, institutional experience, and emerging catheter and pharmacological options may impact complication rates. We assessed procedural complication trends in AF ablation patients from 2003–2015 to identify what factors affect adverse event rates. Methods and Results: We evaluated consecutively enrolled patients undergoing initial AF ablation from 2003 through 2015. Statistical analyses were performed to identify predictors of increased risk for major complications, which were defined as death, stroke, atrio-oesophageal fistula, phrenic nerve injury, cardiovascular events requiring blood transfusions or procedural interventions, or non-cardiovascular events requiring intervention. A total of 1475 patients (mean age 59.5 ± 10.5, 82% male) were evaluated. Major complications occurred in 3.9% (n = 58) of cases, including vascular access-site haematoma (1.3%), cardiac tamponade (1.1%), and cerebrovascular accident (CVA) (0.9%). Univariate analysis revealed increased risk of complications associated with hypertension (P = 0.048), CHA2DS2VASc score ≥1 (P = 0.015), and early institutional experience (P = 0.003). Populations with higher CHA2DS2VASc scores underwent AF ablation more frequently over time (P < 0.001). Novel catheters and anticoagulants did not appreciably affect complication rates. Multivariate analysis adjusting for hypertension, CHA2DS2VASc score, and institutional experience showed that higher CHA2DS2VASc score and early institutional experience were independent predictors of adverse events. Conclusion:Patient characteristics reflected in CHA2DS2VASc scoring and early institutional experience predict increased complication rates following AF ablation. Despite more patients with higher CHA2DS2VASc scores undergoing AF ablation, complication rates fell over time as institutional experience increased.
Authors: Luisa Ciuffo; Hieu Nguyen; Mateus Diniz Marques; Konstantinos N Aronis; Bhradeev Sivasambu; Henrique D de Vasconcelos; Susumu Tao; David D Spragg; Joseph E Marine; Ronald D Berger; Joao A C Lima; Hugh Calkins; Hiroshi Ashikaga Journal: Circ Cardiovasc Imaging Date: 2019-06-10 Impact factor: 7.792
Authors: Luisa Ciuffo; Susumu Tao; Esra Gucuk Ipek; Tarek Zghaib; Muhammad Balouch; Joao A C Lima; Saman Nazarian; David D Spragg; Joseph E Marine; Ronald D Berger; Hugh Calkins; Hiroshi Ashikaga Journal: JACC Cardiovasc Imaging Date: 2018-01-17
Authors: Ka Hou Christien Li; Tian Sang; Cheng Chan; Mengqi Gong; Yingzhi Liu; Aaron Jesuthasan; Guangping Li; Tong Liu; Michael H S Lam; William Kk Wu; Matthew T V Chan; Fang-Zhou Liu; Cheng Chen; Jeffery Ho; Yunlong Xia; Gary Tse Journal: Heart Asia Date: 2019-08-14
Authors: Nándor Szegedi; Gábor Széplaki; Szilvia Herczeg; Tamás Tahin; Zoltán Salló; Vivien Klaudia Nagy; István Osztheimer; Emin Evren Özcan; Béla Merkely; László Gellér Journal: Europace Date: 2019-05-01 Impact factor: 5.214