Delayed cardiac tamponade in catheter ablation for paroxysmal atrial fibrillation induced by a subacute hemorrhage

Ishiguchi, Hironori; Yoshida, Masaaki; Kawabata, Tetsuya; Yoshiga, Yasuhiro; Shimizu, Akihiko; Oda, Tsuyoshi

doi:10.1016/j.hrcr.2020.04.005

Cited by 2 publications

(1 citation statement)

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“…Atrial fibrillation (AF) ablation is one of the substantial treatment options for rhythm control, especially among patients who have symptomatic AF that is refractory to pharmacological and/or electrical cardioversion or among patients who are intolerant to anti-arrhythmic medications [ 1 ]. Cardiac tamponade is a rare complication of catheter ablation for AF or pulmonary vein isolation (PVI) and the incidence of delayed cardiac tamponade (DCT) has been reported as 0.2% [ 2 ]. The effectiveness of cardiac catheter ablation in AF has been well-established recently; however, care needs to be taken to minimize the procedure-related complications [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Cardiac Tamponade During Catheter Atrial Fibrillation Ablation: A Life-Threatening Complication

Khan

2023

Cureus

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Catheter ablation has become an important treatment strategy for the management of atrial fibrillation (AF) in symptomatic patients. Pulmonary vein isolation (PVI) is increasingly used to restore rhythm in patients with AF and flutter. The serious procedural complication rate has significantly reduced over time and most patients undergo PVI without any adverse events. We present the case of a 70-year-old man with symptomatic AF who underwent elective PVI that was complicated by large pericardial effusion from left atrial appendage (LAA) perforation resulting in cardiac tamponade requiring emergency pericardiocentesis followed by sternotomy to suture the LAA. The perforated LAA was sutured and the LAA was closed surgically through sternotomy by using AtriClip and a large amount of blood was evacuated achieving good cardiac output and hemodynamic stability. A surgical PVI was performed twice restoring normal sinus rhythm. The patient was discharged home, however, he returned to the hospital a few days later with atrial flutter with a rapid ventricular response. He underwent direct current cardioversion (DCCV) and remained in sinus rhythm during the rest of his admission. His bisoprolol was switched to Sotalol to maintain normal sinus rhythm and he was discharged home with outpatient follow-up.

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Section: Introductionmentioning

confidence: 99%