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Assessing the perforation site of cardiac tamponade during radiofrequency catheter ablation using gas analysis of pericardial effusion.


ABSTRACT:

Background

The incidence of pericardial effusion (PE) during radiofrequency catheter ablation (CA) for atrial fibrillation is approximately 1%. PE is a major complication during CA, but there has been limited literature about the perforation site responsible.

Objective

This study aimed to retrospectively investigate the characteristics of the procedure and the patients in whom PE developed during CA.

Methods

Of 1363 consecutive patients who underwent catheter ablation from January 2015 to June 2019 in Kyorin University Hospital, we reviewed patients who developed PE during CA.

Results

PE during CA occurred in 18 (1.32%) patients (median age, 71 [interquartile range (IQR) 65-77] years, 7 women). The median body mass index was 24 (IQR 20-27). Target arrhythmias for CA of patients with PE include atrial fibrillation (AF) (n = 13, 72%), premature ventricular contraction (n = 2, 11%), ventricular tachycardia (n = 1, 6%), atrial flutter (n = 1, 6%), and orthodromic reciprocating tachycardia (n = 1, 6%). Seventeen patients required pericardiocentesis, resulting in 300 (IQR 192.5-475) mL of drainage. Two patients required emergency surgical repair, and 1 died from aortic dissection. Based on the gas analysis, the drained blood was of venous origin in 47% of the total events and 54% of AF ablation.

Conclusion

PE caused by a diagnostic catheter in the right heart is not uncommon, even in AF ablation.

PROVIDER: S-EPMC8183862 | BioStudies |

REPOSITORIES: biostudies

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