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Complications arising from catheter ablation of atrial fibrillation: temporal trends and predictors.

Abstract：

BACKGROUND:The reported complication rate of catheter ablation of atrial fibrillation (AF) varies. OBJECTIVE:Our goal was to assess temporal trends and the effect of both institutional and individual operators' experience on the incidence of complications. METHODS:All patients undergoing AF ablation at Johns Hopkins Hospital between February 2001 and December 2010 were prospectively enrolled in a database. Major complications were defined as those that were life-threatening, resulted in permanent harm, required intervention, or significantly prolonged hospitalization. RESULTS:Fifty-six major complications occurred in 1190 procedures (4.7%). The majority of complications were vascular (18; 1.5%), followed by pericardial tamponade (13; 1.1%) and cerebrovascular accident (12; 1.1%). No cases of death or atrioesophageal fistula occurred. The overall complication rate decreased from 11.1% in 2002 to 1.6% in 2010 (P <.05). On univariate analysis, demographic and clinical factors associated with the increased risk of complications were CHADS(2) score of ≥2 (hazard ratio [HR] = 2.5; 95% confidence interval [CI] = 1.4-4.4; P = .002), female gender (HR = 2.0; 95% CI = 1.2-3.5; P = .014), and age (HR = 1.03; 95% CI = 1.0-1.1; P = .042). Gender and CHADS(2) score of ≥2 remained independent predictors of complication on multivariable analysis. CONCLUSION:The complication rate of catheter ablation of AF decreased with increased institutional experience. Female gender and CHADS(2) score of ≥2 are significant independent risk factors for complications and should be considered when referring patients for AF ablation.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Hoyt H,Bhonsale A,Chilukuri K,Alhumaid F,Needleman M,Edwards D,Govil A,Nazarian S,Cheng A,Henrikson CA,Sinha S,Marine JE,Berger R,Calkins H,Spragg DD

doi

10.1016/j.hrthm.2011.07.025

subject

Has Abstract

pub_date

2011-12-01 00:00:00

pages

1869-74

issue

12

eissn

1547-5271

issn

1556-3871

pii

S1547-5271(11)00845-9

journal_volume

8

pub_type

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