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Low risk of major complications associated with pulmonary vein antral isolation for atrial fibrillation: results of 500 consecutive ablation procedures in patients with low prevalence of structural heart disease from a single center.
MedLine Citation:
PMID:  20731742     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Complications Associated With Pulmonary Vein Antral Isolation for Atrial Fibrillation. Objectives: To report the major complication rate associated with pulmonary vein antral isolation (PVAI) in a consecutive series of 500 patients from a single center. Background: Catheter ablation for atrial fibrillation (AF) is an established procedure for refractory AF. However, the risk of major complications has been reported to range from 3.9% to 4.5% and continues to represent a cause for concern. We hypothesized that these studies may have overestimated the rate of major complications associated with PVAI in patients with a low prevalence of structural heart disease (SHD). Methods: Data were prospectively collected from 500 consecutive AF ablation procedures on 424 patients (mean age 55 ± 11 years, 79% men, paroxysmal AF-80% and persistent AF-20%, CHADS(2) scores of 0, 1, 2, 3 present in 64%, 28%, 7%, 1%, respectively), performed between July 2006 and September 2009. All procedures were performed under general anesthesia with intraoperative transesophageal echo. PVAI was performed using a nonfluoroscopic mapping system with an endpoint of PV isolation. Adjunctive left atrial ablation was performed in 21% of patients only. Major complications were defined from a compilation of those reported in 5 prior studies reporting complications. Results: In 500 procedures, there were no instances of death, stroke/TIA, cardiac tamponade, atrioesophageal fistula, or PV stenosis. Major complications occurred in 4 procedures (0.8%): esophageal hematoma (TEE probe)-2; pharyngeal trauma-1; and retroperitoneal hematoma-1. Conclusions: AF ablation can be performed safely in young patients without structural heart disease with a low risk (<1%) of major complications when using a strategy of PVAI. (J Cardiovasc Electrophysiol, Vol. 22, pp. 163-168, February 2011).
Authors:
Geoffrey Lee; Paul B Sparks; Joseph B Morton; Peter M Kistler; Jitendra K Vohra; Caroline Medi; Raphael Rosso; Andrew Teh; Karen Halloran; Jonathan M Kalman
Publication Detail:
Type:  Journal Article     Date:  2010-08-19
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  22     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  163-8     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley Periodicals, Inc.
Affiliation:
Department of Cardiology, Royal Melbourne Hospital and the Department of Medicine, University of Melbourne, Melbourne, Australia.
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