Creating Diamonds From Dust: How Experts Manage Ablation Complications-Creating Diamonds From Dust: How Experts Manage Ablation Complications

Video Transcription

Video Summary

The session "Creating Diamonds from Dust: How Experts Manage Ablation Complications" featured experts sharing their experiences with complications during ablation procedures. Bill Miles presented a case involving a 65-year-old woman with atrial fibrillation, where a post-procedure echocardiogram revealed a large mass in the left atrium, later identified as an intramural hematoma. This was managed conservatively with successful resolution over time. Professor Boris Schmidt shared his worst complication during pulse field ablation, involving a patient who unexpectedly died hours after the procedure due to an apparent coronary spasm, despite no evident coronary artery disease or thrombus. Dr. Rod Tung recounted a challenging case where a decision to ablate a PVC during a routine PVI led to the development of a large ventricular pseudoaneurysm, requiring surgical intervention. This event almost led him to consider leaving electrophysiology due to its emotional impact. Finally, Professor Kiyoko Tsujima discussed a case where iatrogenic trauma to the aortic intima during retrograde catheter manipulation resulted in a fatal tamponade. The panel emphasized the importance of humility and learning from complications to improve patient outcomes and personal resilience. The session encouraged open discussions about mistakes and advocated for better understanding and prevention of rare but serious complications like coronary spasms and vascular injuries.

Keywords

ablation complications

atrial fibrillation

intramural hematoma

pulse field ablation

coronary spasm

ventricular pseudoaneurysm

electrophysiology

iatrogenic trauma

patient outcomes

vascular injuries