Incidence and predictors of pericardial effusion as an early complication of catheter ablation for atrial fibrillation: The Japanese Catheter Ablation Registry of Atrial Fibrillation (J‐CARAF)

Murakawa, Yuji; Yamane, Teiichi; Goya, Masahiko; Inoue, Koichi; Naito, Shigeto; Kumagai, Koji; Miyauchi, Yasushi; Morita, Norishige; Nogami, Akihiko; Shoda, Morio; Okumura, Ken; Hirao, Kazuyuki

doi:10.1016/j.joa.2017.04.009

Cited by 17 publications

(12 citation statements)

References 18 publications

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“…They showed that use of three-dimensional mapping system and use of novel oral anticoagulants are independent predictors of lower incidence of pericardial effusion. Repeat ablation procedures were included in the analysis but they did not find significant difference regarding the incidence of pericardial effusion between initial and repeated ablation procedures 14 . Their statistical analysis investigated pericardial effusions only, which might be an explanation why these results does not converge with our findings.…”

Section: Discussioncontrasting

confidence: 56%

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

et al. 2019

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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), CHA 2 DS 2 -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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Section: Discussioncontrasting

confidence: 56%

“…Recent studies reported various predictors of complications, however, most of them were derived from cohorts where only first ablation procedures were included 2 , 4–14 . Therefore limited data exist regarding the role and predictive value of a repeat procedure on procedural outcomes 2 , 11 , 14 …”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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“…Deep sedation, reduced left ventricular function, warfarin, AF, and female sex have been reported as risk factors for PE. 2 , 10 Of these 5 risks, they distributed from 0 to 3 points in this study. Another paper reported that no significant factors are associated with the occurrence of tamponade, including age, body mass index, sex, AF type, left atrial dimension, use of an RF needle, operators, peak ACT, and direct oral anticoagulant use except for the use of a cryoballoon.…”

Section: Discussionmentioning

confidence: 99%

“…Pericardial effusion (PE) due to cardiac perforation is a known major complication of radiofrequency (RF) catheter ablation (CA). The reported incidence of PE during CA was 0.5%–4.0% for atrial fibrillation (AF) 1 , 2 and 2% for ventricular tachycardia (VT). 3 , 4 It can be caused by mechanical trauma during catheter manipulation, inadvertent injury during transseptal puncture, or steam pop during CA.…”

Section: Introductionmentioning

confidence: 99%

Assessing the perforation site of cardiac tamponade during radiofrequency catheter ablation using gas analysis of pericardial effusion

et al. 2020

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BACKGROUND The incidence of pericardial effusion (PE) during radiofrequency catheter ablation (CA) for atrial fibrillation is approximately 1%. PE is a major complication during CA, but there has been limited literature about the perforation site responsible. OBJECTIVE This study aimed to retrospectively investigate the characteristics of the procedure and the patients in whom PE developed during CA. METHODS Of 1363 consecutive patients who underwent catheter ablation from January 2015 to June 2019 in Kyorin University Hospital, we reviewed patients who developed PE during CA. RESULTS PE during CA occurred in 18 (1.32%) patients (median age, 71 [interquartile range (IQR) 65-77] years, 7 women). The median body mass index was 24 (IQR 20-27). Target arrhythmias for CA of patients with PE include atrial fibrillation (AF) (n 5 13, 72%), premature ventricular contraction (n 5 2, 11%), ventricular tachycardia (n 5 1, 6%), atrial flutter (n 5 1, 6%), and orthodromic reciprocating tachycardia (n 5 1, 6%). Seventeen patients required pericardiocentesis, resulting in 300 (IQR 192.5-475) mL of drainage. Two patients required emergency surgical repair, and 1 died from aortic dissection. Based on the gas analysis, the drained blood was of venous origin in 47% of the total events and 54% of AF ablation. CONCLUSION PE caused by a diagnostic catheter in the right heart is not uncommon, even in AF ablation.

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“…This registry included cases performed not only in high-volume centers but also low-volume ones and published reports continuously. [5][6][7][8][9][10][11][12] However, this registry included exclusively AF ablation cases performed in September and features of other arrhythmias were not investigated. In contrast to these preceding registries, the current J-AB registry is taking a step forward since it is aiming to collect all catheter ablation cases performed in one country, from various types of centers (small-and largevolume centers), to reveal the current real-world status of catheter ablation in Japan.…”

Section: Discussionmentioning

confidence: 99%

Study design of nationwide Japanese Catheter Ablation Registry: Protocol for a prospective, multicenter, open registry

Yamane

Inoue

Kusano

et al. 2019

Journal of Arrhythmia

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Background Catheter ablation has become a popular interventional treatment for cardiac tachyarrhythmias and the number has been on the rise year by year. However, little is known about its efficacy and safety in the real‐world settings. Method Japanese Catheter Ablation (J‐ AB ) Registry is a nationwide, multicenter, observational registry, performed by Japanese Heart Rhythm Society (JHRS), collaborated with National Cerebral and Cardiovascular Center. This study is a voluntary nationwide registry and data are collected prospectively using a Research Electronic Data Capture (REDCap) system. Detailed data collection including antiarrhythmic medication is also performed every September. The acute success rate at discharge and the complications associated with ablation procedure will be collected in all cases. Major bleeding events are defined according to Bleeding Academic Research Consortium criteria. Based on the provided information, the annual incidence and predictive factors for outcome will be investigated by the Event Assessment Committee. This registry started in August 2017 and the number of participating medical instructions will be more than 250 hospitals and the target procedure number will be 70 000 per year. We will also compare the results with other registries in foreign countries. Result The results of this study are currently under investigation. Conclusion The J‐ AB registry will provide a real‐world data regarding the acute success and complications in Japan, focusing on various types of catheter ablation for cardiac arrhythmias.

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Incidence and predictors of pericardial effusion as an early complication of catheter ablation for atrial fibrillation: The Japanese Catheter Ablation Registry of Atrial Fibrillation (J‐CARAF)

Cited by 17 publications

References 18 publications

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

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

Assessing the perforation site of cardiac tamponade during radiofrequency catheter ablation using gas analysis of pericardial effusion

Study design of nationwide Japanese Catheter Ablation Registry: Protocol for a prospective, multicenter, open registry

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