The Lead Episode 17: A Discussion of Procedure-Related Complications of Catheter Ablation for Atrial Fibrillation-Journal of the American College of Cardiology

Journal of the American College of Cardiology

Pdf Summary

Catheter ablation is a commonly performed procedure for the treatment of atrial fibrillation (AF), but it is associated with potential complications. This systematic review and meta-analysis aimed to determine the rate of procedure-related complications associated with catheter ablation of AF using data from randomized controlled trials (RCTs) and assess temporal trends. The analysis included 89 RCTs with a total of 15,701 patients undergoing their first ablation procedure. The overall rate of procedure-related complications was found to be 4.51%, with severe complications occurring in 2.44% of cases. Vascular complications were the most frequently reported complication, followed by pericardial effusion/tamponade and stroke/transient ischemic attack. The analysis also found a significant decrease in the overall complication rate in the more recent 5-year period compared to the previous 5-year period. The pooled mortality rate was stable over the two time periods. There was no significant difference in complication rates according to pattern of AF, ablation modality, or ablation strategies beyond pulmonary vein isolation. The study concludes that the rates of procedure-related complications and mortality associated with catheter ablation of AF are low and have declined over the past decade.

Keywords

Catheter ablation

Atrial fibrillation

Procedure-related complications

Randomized controlled trials

Temporal trends

Vascular complications

Pericardial effusion

Tamponade

Stroke

Transient ischemic attack