Document Detail


Incidence, risk factors, and consequences of new-onset atrial fibrillation following epicardial ablation for ventricular tachycardia.
MedLine Citation:
PMID:  21296778     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: We sought to determine the incidence, predictors, and consequences of new-onset atrial fibrillation (AF) following epicardial ventricular tachycardia (VT) ablation.
METHODS AND RESULTS: A total of 41 patients with no prior history of AF underwent epicardial VT ablation via a percutaneous subxiphoid approach. All patients were monitored continuously for 3 days following ablation and then via implantable cardiac defibrillator (ICD) or Holter monitoring. Mean age was 70.0 ± 11.3 years and mean ejection fraction was 30.3 ± 16.6%. In seven (17%) patients, the right ventricle (RV) was punctured during access with subsequent needle withdrawal without requiring surgical repair. Thirty patients (73%) were treated with amiodarone following ablation. Post-ablation, eight (19.5%) patients had documented new-onset AF within 7 days. All AF patients had clinical symptoms of pericarditis. One patient with AF was maintained on amiodarone post-procedure. Complications of AF included three patients who received inappropriate ICD shocks and one patient who developed a large, left atrial appendage clot. Acutely, all patients responded to short-term medical therapy or electrical cardioversion. At 18.0 ± 9.0 months of follow-up, no patient had recurrence of AF, and all were off antiarrhythmic drugs. One patient had typical atrial flutter requiring catheter ablation. Risk factors for AF included lack of amiodarone immediately after ablation (12.5 vs. 87.9%, P < 0.001), RV puncture (50.0 vs. 9.1%, P = 0.02), and epicardial ablation time >10 min (62.5 vs. 3.0%, P < 0.001).
CONCLUSIONS: Atrial fibrillation after epicardial ablation is common and can lead to ICD shocks and atrial thrombus formation. Short-term antiarrhythmic drug therapy and ICD reprogramming should be considered after epicardial VT ablation.
Authors:
Srijoy Mahapatra; Damien J LaPar; Castigliano M Bhamidipati; George McDaniel; Sandeep Kamath; T Jared Bunch; Gorav Ailawadi
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-02-04
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  13     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-30     Completed Date:  2011-08-11     Revised Date:  2012-04-12    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  548-54     Citation Subset:  IM    
Affiliation:
Division of Cardiology/Electrophysiology, University of Virginia, PO Box 800679, Charlottesville, VA 22908, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / epidemiology*,  physiopathology,  therapy
Catheter Ablation / adverse effects*
Defibrillators, Implantable
Electrocardiography, Ambulatory
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Risk Factors
Tachycardia, Ventricular / surgery*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
2T32HL007849-11A1/HL/NHLBI NIH HHS; T32 HL007849-11A1/HL/NHLBI NIH HHS

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