Complications of pulmonary vein isolation in atrial fibrillation: predictors and comparison between four different ablation techniques: Results from the MIddelheim PVI-registry

Greef, Yves De; Ströker, Edwin; Schwagten, Bruno; Kupics, Kaspars; Cocker, Jeroen De; Chierchia, Gian‐Battista; Asmundis, Carlo de; Stockman, Dirk; Buysschaert, Ian

doi:10.1093/europace/eux233

Cited by 70 publications

(73 citation statements)

References 21 publications

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“…This might be a result of the fact, that experienced operators performed more complex procedures. Female sex was not associated with higher complication rates as it is described in the literature [16][17][18][19][20][21]. This could be partly explained by a relatively small ablation cohort and a low number of complications.…”

Section: Complicationsmentioning

confidence: 47%

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Impact of single versus double transseptal puncture on outcome and complications in pulmonary vein isolation procedures

et al. 2021

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Background:The aim of the current study was to analyze the impact of single versus double transseptal puncture (TSP) for atrial fibrillation (AF) ablation. Methods:Consecutive patients undergoing AF ablation were prospectively included in the AF ablation registry and were analyzed according to single versus double TSP. Results:A total of 478 patients (female 35%, persistent AF 67%) undergoing AF ablation between 01/2014 and 09/2014 were included. Single TSP was performed in 202 (42%) patients, double TSP in 276 (58%) patients. Age, gender, body mass index, CHA2DS2-VASc score, left ventricular ejection fraction and operator experience (experienced operator defined as ≥ 5 years of experience in invasive electrophysiology) were equally distributed between the two groups. Repeat procedures (re-dos) were more frequently performed using single TSP access (p < 0.001). Left atrial (LA) diameter was larger in patients with double TSP (p = 0.001). Procedure duration in single TSP was identical to double TSP procedures (p = 0.823).Radiation duration was similar between the two groups (p = 0.217). There were 49 (10%) patients with complications after catheter ablation. There were no differences between complication rates and TSP type (p = 0.555). Similarly, recurrence rates were comparable between both TSP groups (p = 0.788). Conclusion:There was no clear benefit of single or double TSP in AF ablation.

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Section: Complicationsmentioning

confidence: 47%

“…Neither was a higher CHA2DS2-VASc Score associated with higher complication rate. CHA2DS2-VASc score and early institutional experience showed a higher complication rate in the literature [19][20][21][22]. This was also attributed to the small sample size and low complication rate.…”

Section: Complicationsmentioning

confidence: 94%

Impact of single versus double transseptal puncture on outcome and complications in pulmonary vein isolation procedures

et al. 2021

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“…In this context, the involvement of greater areas in the ablation maybe important in the case of ATs originating alongside the PVs like in the present report. Furthermore, a large register study showed that the complication rates with CB ablation are lower than those with point‐per‐point RF ablation . The ability to perform ablation with the CB as a “single‐shot” device without the needing of more than one transseptal puncture in patients with an unusual left atrial anatomy is an additional argument for performing this ablation procedure empirically in CB technique.…”

Section: Discussionmentioning

confidence: 99%

Successful cryoballoon ablation of a focal atrial tachycardia in a patient with situs inversus and dextrocardia

Akkaya

Sözener

Rixe

et al. 2019

Clinical Case Reports

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“…Previous, mostly small studies on the second-generation PVAC GOLD catheter reported major complications ranging from 0 to 6.5% [6][7][8]15]. More recent and larger studies by Spitzer et al and De Greef et al showed more comparable major complication rates below 2% [15,18].…”

Section: Safety Outcomesmentioning

confidence: 91%

Acute success and safety of the second-generation PVAC GOLD phased RF ablation catheter for atrial fibrillation

Klaver¹,

Wintgens

Wijffels

et al. 2020

J Interv Card Electrophysiol

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Purpose The second-generation multi-electrode catheter, pulmonary vein ablation catheter (PVAC) GOLD, was designed to improve the delivery of phased radiofrequency energy and reduce procedure times using a 'single-shot' approach for pulmonary vein isolation (PVI), while retaining efficacy and safety. This large registry presents acute success rates and safety outcomes in a daily practice setting. Methods A total of 1017 patients undergoing first-time ablation for atrial fibrillation (AF) using PVAC GOLD were included, 644 patients with paroxysmal AF and 373 patients with non-paroxysmal AF, divided into 175 patients receiving PVI only and 198 patients receiving PVI with additional substrate modification. Results High and comparable percentages of successful PVI could be achieved in all groups (98%, 95% and 99%; p = 0.108). The median total procedure time for all groups was 90 min [70-100]. As expected, the total procedure, ablation and fluoroscopy time were significantly longer in the PVI + substrate modification group compared with the PVI-only cases (all p < 0.001), but not between the PVI-only groups (p = 0.306, p = 0.088, p = 0.233, respectively). A total of 44 complications were observed in 43 patients (4.2%). Major complications were seen in 19 patients (1.87%) and non-major procedure-related complications were seen in 25 patients (2.46%). Complications leaving permanent sequelae were rare and occurred in only four patients (0.39%). Complications did not differ between groups (p = 0.199, p = 0.438, p = 0.240 and p = 0.465 respectively). Conclusion PVAC GOLD performs successful PVI, while reducing procedure times and retaining safety for paroxysmal, persistent and long-standing persistent AF. Safety was unaffected by additional substrate modification.

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Complications of pulmonary vein isolation in atrial fibrillation: predictors and comparison between four different ablation techniques: Results from the MIddelheim PVI-registry

Cited by 70 publications

References 21 publications

Impact of single versus double transseptal puncture on outcome and complications in pulmonary vein isolation procedures

Impact of single versus double transseptal puncture on outcome and complications in pulmonary vein isolation procedures

Successful cryoballoon ablation of a focal atrial tachycardia in a patient with situs inversus and dextrocardia

Acute success and safety of the second-generation PVAC GOLD phased RF ablation catheter for atrial fibrillation

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