Complications of catheter ablation for atrial fibrillation: Incidence and predictors

David D. Spragg, Darshan Dalal, Aamir Cheema, Daniel Scherr, Karuna Chilukuri, Alan Cheng, Charles Henrikson, Joseph E. Marine, Ronald D. Berger, Jun Dong, Hugh Calkins

Research output: Contribution to journalArticle

200 Citations (Scopus)

Abstract

Catheter Ablation Atrial Fibrillation. Introduction: Pulmonary vein (PV) isolation by catheter ablation is an increasingly used strategy to treat atrial fibrillation (AF). Complication rates from AF ablation reported in different case series vary widely. We conducted a retrospective analysis of 641 consecutive ablation procedures to assess complication rates, temporal trends, and clinical predictors of adverse outcomes. Methods: All patients (n = 517) undergoing catheter ablation for AF at Johns Hopkins Hospital between February, 2001 and June, 2007 were prospectively enrolled in a database. Data from 641 consecutive procedures were analyzed and complications considered if they occurred within 30 days of ablation. Major complications were defined as those that required intervention, resulted in long-term disability, or prolonged hospitalization. Results: Thirty-two major complications occurred in 641 procedures (5%). Among the patients with major complications, seven had cerebrovascular accident (CVA), eight had tamponade, one had PV occlusion with hemoptysis, and 11 had vascular injury requiring surgical repair and/or transfusion. No periprocedural deaths occurred, and no instances of esophageal injury were seen. Complication rates were higher during the first 100 cases (9.0%) than during the subsequent 541 (4.3%). Major adverse clinical events were associated with age > 70 years (P = 0.007; odds ratio 3.7, 95% confidence interval 1.4-9.6) and female gender (P = 0.014; odds ratio 3.0, 95% confidence interval 1.3-7.2). No other clinical or procedural predictors of complication were identified. Conclusions: Complication rates from AF ablation remain significant, despite improved techniques and increased awareness of procedural risks. Both advanced age and female gender predict major adverse events, suggesting careful consideration of the risk/benefit profile in these patients prior to ablation.

Original languageEnglish (US)
Pages (from-to)627-631
Number of pages5
JournalJournal of Cardiovascular Electrophysiology
Volume19
Issue number6
DOIs
StatePublished - Jun 2008
Externally publishedYes

Fingerprint

Catheter Ablation
Atrial Fibrillation
Incidence
Pulmonary Veins
Odds Ratio
Confidence Intervals
Hemoptysis
Vascular System Injuries
Hospitalization
Stroke
Databases
Wounds and Injuries

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Complication

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Spragg, D. D., Dalal, D., Cheema, A., Scherr, D., Chilukuri, K., Cheng, A., ... Calkins, H. (2008). Complications of catheter ablation for atrial fibrillation: Incidence and predictors. Journal of Cardiovascular Electrophysiology, 19(6), 627-631. https://doi.org/10.1111/j.1540-8167.2008.01181.x

Complications of catheter ablation for atrial fibrillation : Incidence and predictors. / Spragg, David D.; Dalal, Darshan; Cheema, Aamir; Scherr, Daniel; Chilukuri, Karuna; Cheng, Alan; Henrikson, Charles; Marine, Joseph E.; Berger, Ronald D.; Dong, Jun; Calkins, Hugh.

In: Journal of Cardiovascular Electrophysiology, Vol. 19, No. 6, 06.2008, p. 627-631.

Research output: Contribution to journalArticle

Spragg, DD, Dalal, D, Cheema, A, Scherr, D, Chilukuri, K, Cheng, A, Henrikson, C, Marine, JE, Berger, RD, Dong, J & Calkins, H 2008, 'Complications of catheter ablation for atrial fibrillation: Incidence and predictors', Journal of Cardiovascular Electrophysiology, vol. 19, no. 6, pp. 627-631. https://doi.org/10.1111/j.1540-8167.2008.01181.x
Spragg, David D. ; Dalal, Darshan ; Cheema, Aamir ; Scherr, Daniel ; Chilukuri, Karuna ; Cheng, Alan ; Henrikson, Charles ; Marine, Joseph E. ; Berger, Ronald D. ; Dong, Jun ; Calkins, Hugh. / Complications of catheter ablation for atrial fibrillation : Incidence and predictors. In: Journal of Cardiovascular Electrophysiology. 2008 ; Vol. 19, No. 6. pp. 627-631.
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abstract = "Catheter Ablation Atrial Fibrillation. Introduction: Pulmonary vein (PV) isolation by catheter ablation is an increasingly used strategy to treat atrial fibrillation (AF). Complication rates from AF ablation reported in different case series vary widely. We conducted a retrospective analysis of 641 consecutive ablation procedures to assess complication rates, temporal trends, and clinical predictors of adverse outcomes. Methods: All patients (n = 517) undergoing catheter ablation for AF at Johns Hopkins Hospital between February, 2001 and June, 2007 were prospectively enrolled in a database. Data from 641 consecutive procedures were analyzed and complications considered if they occurred within 30 days of ablation. Major complications were defined as those that required intervention, resulted in long-term disability, or prolonged hospitalization. Results: Thirty-two major complications occurred in 641 procedures (5{\%}). Among the patients with major complications, seven had cerebrovascular accident (CVA), eight had tamponade, one had PV occlusion with hemoptysis, and 11 had vascular injury requiring surgical repair and/or transfusion. No periprocedural deaths occurred, and no instances of esophageal injury were seen. Complication rates were higher during the first 100 cases (9.0{\%}) than during the subsequent 541 (4.3{\%}). Major adverse clinical events were associated with age > 70 years (P = 0.007; odds ratio 3.7, 95{\%} confidence interval 1.4-9.6) and female gender (P = 0.014; odds ratio 3.0, 95{\%} confidence interval 1.3-7.2). No other clinical or procedural predictors of complication were identified. Conclusions: Complication rates from AF ablation remain significant, despite improved techniques and increased awareness of procedural risks. Both advanced age and female gender predict major adverse events, suggesting careful consideration of the risk/benefit profile in these patients prior to ablation.",
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T2 - Incidence and predictors

AU - Spragg, David D.

AU - Dalal, Darshan

AU - Cheema, Aamir

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AU - Chilukuri, Karuna

AU - Cheng, Alan

AU - Henrikson, Charles

AU - Marine, Joseph E.

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N2 - Catheter Ablation Atrial Fibrillation. Introduction: Pulmonary vein (PV) isolation by catheter ablation is an increasingly used strategy to treat atrial fibrillation (AF). Complication rates from AF ablation reported in different case series vary widely. We conducted a retrospective analysis of 641 consecutive ablation procedures to assess complication rates, temporal trends, and clinical predictors of adverse outcomes. Methods: All patients (n = 517) undergoing catheter ablation for AF at Johns Hopkins Hospital between February, 2001 and June, 2007 were prospectively enrolled in a database. Data from 641 consecutive procedures were analyzed and complications considered if they occurred within 30 days of ablation. Major complications were defined as those that required intervention, resulted in long-term disability, or prolonged hospitalization. Results: Thirty-two major complications occurred in 641 procedures (5%). Among the patients with major complications, seven had cerebrovascular accident (CVA), eight had tamponade, one had PV occlusion with hemoptysis, and 11 had vascular injury requiring surgical repair and/or transfusion. No periprocedural deaths occurred, and no instances of esophageal injury were seen. Complication rates were higher during the first 100 cases (9.0%) than during the subsequent 541 (4.3%). Major adverse clinical events were associated with age > 70 years (P = 0.007; odds ratio 3.7, 95% confidence interval 1.4-9.6) and female gender (P = 0.014; odds ratio 3.0, 95% confidence interval 1.3-7.2). No other clinical or procedural predictors of complication were identified. Conclusions: Complication rates from AF ablation remain significant, despite improved techniques and increased awareness of procedural risks. Both advanced age and female gender predict major adverse events, suggesting careful consideration of the risk/benefit profile in these patients prior to ablation.

AB - Catheter Ablation Atrial Fibrillation. Introduction: Pulmonary vein (PV) isolation by catheter ablation is an increasingly used strategy to treat atrial fibrillation (AF). Complication rates from AF ablation reported in different case series vary widely. We conducted a retrospective analysis of 641 consecutive ablation procedures to assess complication rates, temporal trends, and clinical predictors of adverse outcomes. Methods: All patients (n = 517) undergoing catheter ablation for AF at Johns Hopkins Hospital between February, 2001 and June, 2007 were prospectively enrolled in a database. Data from 641 consecutive procedures were analyzed and complications considered if they occurred within 30 days of ablation. Major complications were defined as those that required intervention, resulted in long-term disability, or prolonged hospitalization. Results: Thirty-two major complications occurred in 641 procedures (5%). Among the patients with major complications, seven had cerebrovascular accident (CVA), eight had tamponade, one had PV occlusion with hemoptysis, and 11 had vascular injury requiring surgical repair and/or transfusion. No periprocedural deaths occurred, and no instances of esophageal injury were seen. Complication rates were higher during the first 100 cases (9.0%) than during the subsequent 541 (4.3%). Major adverse clinical events were associated with age > 70 years (P = 0.007; odds ratio 3.7, 95% confidence interval 1.4-9.6) and female gender (P = 0.014; odds ratio 3.0, 95% confidence interval 1.3-7.2). No other clinical or procedural predictors of complication were identified. Conclusions: Complication rates from AF ablation remain significant, despite improved techniques and increased awareness of procedural risks. Both advanced age and female gender predict major adverse events, suggesting careful consideration of the risk/benefit profile in these patients prior to ablation.

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KW - Catheter ablation

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