Repeat procedure is a new independent predictor of complications of atrial fibrillation ablation

Nándor Szegedi, G. Széplaki, Szilvia Herczeg, Tamás Tahin, Zoltán Salló, Vivien Klaudia Nagy, István Osztheimer, Emin Evren Özcan, B. Merkely, L. Gellér

Research output: Contribution to journalArticle

Abstract

Aims: Atrial fibrillation (AF) ablation has made huge progress with respect to innovation, efficacy, and safety, however, complications are still present. Recent studies examined various predictors of complications. However, limited data exist regarding the role of a repeat procedure. Our aim was the prospective evaluation of the incidence and predictors of complications related to AF ablation procedures in consecutive patients, including repeat procedures. Methods and results: All ablation procedures for AF between January 2013 and December 2015 were analysed in our electrophysiology laboratory. During the study period 1243 procedures were analysed [394 female, median age 62 (55-69)]. Overall complication rate was 6.84%, major complication rate was 2.82%. Major complications were the following: 18 pericardial tamponades; 5 pseudoaneurysms; 1 arteriovenous fistula; 6 thromboembolic cerebrovascular events; 3 pulmonary vein stenosis; and 2 atrioventricular blocks. No atrio-oesophageal fistula or procedure related death occurred. Univariate analysis for overall complications showed that age ≥ 65 years (P = 0.0231), female gender (P = 0.0438), hypertension (P = 0.0488), CHA2DS2-VASc score ≥ 2 (P = 0.0156), and previous AF ablation procedure (P < 0.0001) is associated with higher risk for adverse events. Multivariate analysis showed that the only independent predictor of overall complications was previous AF ablation procedure (P < 0.0001). Similarly, the only predictor of major complications was previous AF ablation procedure (P < 0.0001). Conclusion: Incidence of complications associated with AF ablation in our high volume electrophysiology laboratory is similar to other cohorts. The only independent predictor of complications was previous AF ablation procedure in our series.

Original languageEnglish
Pages (from-to)732-737
Number of pages6
JournalEuropace
Volume21
Issue number5
DOIs
Publication statusPublished - Jan 1 2019

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Atrial Fibrillation
Electrophysiology
Esophageal Fistula
Cardiac Tamponade
Atrioventricular Block
False Aneurysm
Incidence
Arteriovenous Fistula
Multivariate Analysis
Hypertension
Safety

Keywords

  • Ablation
  • Atrial fibrillation
  • Complication
  • Incidence
  • Predictors
  • Repeat procedure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Repeat procedure is a new independent predictor of complications of atrial fibrillation ablation. / Szegedi, Nándor; Széplaki, G.; Herczeg, Szilvia; Tahin, Tamás; Salló, Zoltán; Nagy, Vivien Klaudia; Osztheimer, István; Özcan, Emin Evren; Merkely, B.; Gellér, L.

In: Europace, Vol. 21, No. 5, 01.01.2019, p. 732-737.

Research output: Contribution to journalArticle

Szegedi, N, Széplaki, G, Herczeg, S, Tahin, T, Salló, Z, Nagy, VK, Osztheimer, I, Özcan, EE, Merkely, B & Gellér, L 2019, 'Repeat procedure is a new independent predictor of complications of atrial fibrillation ablation', Europace, vol. 21, no. 5, pp. 732-737. https://doi.org/10.1093/europace/euy326
Szegedi, Nándor ; Széplaki, G. ; Herczeg, Szilvia ; Tahin, Tamás ; Salló, Zoltán ; Nagy, Vivien Klaudia ; Osztheimer, István ; Özcan, Emin Evren ; Merkely, B. ; Gellér, L. / Repeat procedure is a new independent predictor of complications of atrial fibrillation ablation. In: Europace. 2019 ; Vol. 21, No. 5. pp. 732-737.
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AU - Szegedi, Nándor

AU - Széplaki, G.

AU - Herczeg, Szilvia

AU - Tahin, Tamás

AU - Salló, Zoltán

AU - Nagy, Vivien Klaudia

AU - Osztheimer, István

AU - Özcan, Emin Evren

AU - Merkely, B.

AU - Gellér, L.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Aims: Atrial fibrillation (AF) ablation has made huge progress with respect to innovation, efficacy, and safety, however, complications are still present. Recent studies examined various predictors of complications. However, limited data exist regarding the role of a repeat procedure. Our aim was the prospective evaluation of the incidence and predictors of complications related to AF ablation procedures in consecutive patients, including repeat procedures. Methods and results: All ablation procedures for AF between January 2013 and December 2015 were analysed in our electrophysiology laboratory. During the study period 1243 procedures were analysed [394 female, median age 62 (55-69)]. Overall complication rate was 6.84%, major complication rate was 2.82%. Major complications were the following: 18 pericardial tamponades; 5 pseudoaneurysms; 1 arteriovenous fistula; 6 thromboembolic cerebrovascular events; 3 pulmonary vein stenosis; and 2 atrioventricular blocks. No atrio-oesophageal fistula or procedure related death occurred. Univariate analysis for overall complications showed that age ≥ 65 years (P = 0.0231), female gender (P = 0.0438), hypertension (P = 0.0488), CHA2DS2-VASc score ≥ 2 (P = 0.0156), and previous AF ablation procedure (P < 0.0001) is associated with higher risk for adverse events. Multivariate analysis showed that the only independent predictor of overall complications was previous AF ablation procedure (P < 0.0001). Similarly, the only predictor of major complications was previous AF ablation procedure (P < 0.0001). Conclusion: Incidence of complications associated with AF ablation in our high volume electrophysiology laboratory is similar to other cohorts. The only independent predictor of complications was previous AF ablation procedure in our series.

AB - Aims: Atrial fibrillation (AF) ablation has made huge progress with respect to innovation, efficacy, and safety, however, complications are still present. Recent studies examined various predictors of complications. However, limited data exist regarding the role of a repeat procedure. Our aim was the prospective evaluation of the incidence and predictors of complications related to AF ablation procedures in consecutive patients, including repeat procedures. Methods and results: All ablation procedures for AF between January 2013 and December 2015 were analysed in our electrophysiology laboratory. During the study period 1243 procedures were analysed [394 female, median age 62 (55-69)]. Overall complication rate was 6.84%, major complication rate was 2.82%. Major complications were the following: 18 pericardial tamponades; 5 pseudoaneurysms; 1 arteriovenous fistula; 6 thromboembolic cerebrovascular events; 3 pulmonary vein stenosis; and 2 atrioventricular blocks. No atrio-oesophageal fistula or procedure related death occurred. Univariate analysis for overall complications showed that age ≥ 65 years (P = 0.0231), female gender (P = 0.0438), hypertension (P = 0.0488), CHA2DS2-VASc score ≥ 2 (P = 0.0156), and previous AF ablation procedure (P < 0.0001) is associated with higher risk for adverse events. Multivariate analysis showed that the only independent predictor of overall complications was previous AF ablation procedure (P < 0.0001). Similarly, the only predictor of major complications was previous AF ablation procedure (P < 0.0001). Conclusion: Incidence of complications associated with AF ablation in our high volume electrophysiology laboratory is similar to other cohorts. The only independent predictor of complications was previous AF ablation procedure in our series.

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KW - Complication

KW - Incidence

KW - Predictors

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