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Incidence and predictors of invasively-treated pericardial effusion during catheter ablation of atrial fibrillation in Japan

Session Poster Session 2

Speaker Yuji Murakawa

Event : ESC Congress 2019

  • Topic : arrhythmias and device therapy
  • Sub-topic : Catheter Ablation of Arrhythmias
  • Session type : Poster Session

Authors : Y Murakawa (Kawasaki,JP), T Yamane (Tokyo,JP), M Goya (Tokyo,JP), K Inoue (Osaka,JP), S Naito (Maebashi,JP), Y Miyauchi (Tokyo,JP), N Morita (Hachioji,JP), A Nogami (Tsukuba,JP), M Shoda (Tokyo,JP), K Okumura (Kumamoto,JP), K Hirao (Tokyo,JP)

Authors:
Y. Murakawa1 , T. Yamane2 , M. Goya3 , K. Inoue4 , S. Naito5 , Y. Miyauchi6 , N. Morita7 , A. Nogami8 , M. Shoda9 , K. Okumura10 , K. Hirao3 , 1Teikyo University School of Medicine, Fourth Department of Internal Medicine - Kawasaki - Japan , 2Jikei University School of Medicine (Tokyo), Department of Cardiology - Tokyo - Japan , 3Tokyo Medical and Dental University, Heart Rhythm Center - Tokyo - Japan , 4Sakurabashi-Watanabe Hospital - Osaka - Japan , 5Gunma Prefectural Cardiovascular Center - Maebashi - Japan , 6Nippon Medical School - Tokyo - Japan , 7Tokai University Hachioji Hospital, Division of Cardiology - Hachioji - Japan , 8Tsukuba University, Cardiovascular Division - Tsukuba - Japan , 9Tokyo Women's Medical University, Department of Cardiology - Tokyo - Japan , 10Saiseikai Kumamoto Hospital, Division of Cardiology - Kumamoto - Japan ,

Topic(s):
Catheter Ablation of Arrhythmias

Citation:
European Heart Journal ( 2019 ) 40 ( Supplement ), 1158

Purpose and method: Japanese Heart Rhythm Society requested electrophysiology centers to register the data of patients who underwent catheter ablation for atrial fibrillation (AF) in designated eight months from 2011 to 2017. We assessed the incidence and predictors of pericardial effusion (PE) as an early complication of AF ablation.

Results: More than two hundred EP centers reported the data of 13,233 AF ablation cases (age; 64.2±10.7 years, male; 72.6%, paroxysmal AF; 63.4%). Clinically significant complications occurred in 601 subjects (4.5%). Critical PE occurred in 116 patients (0.8%), while six of them required open-chest surgery. Overall complication rate did not show significant changes. In contrast, incidence of PE declined over time (2012:1.2%, 2017:0.5%, p=0.003). Multiple logistic regression analysis showed that seven factors were related with higher incidence of PE. Among these factors, primary extra-PV ablation and hypertrophic cardiomyopathy (HCM) were more remarkably associated with higher rate of PE (PVI[−] vs. PVI[+]= 9.0% vs. 0.8%, OR 12.3, p<0.001; HCM: [+] vs. [−] = 2.6% vs. 0.8%, OR 3.26, p=0.001). Comorbidity of coronary artery disease (CAD) and use of CARTO system were related with lower PE rate (CAD: [+] vs [−] = 0.2% vs. 0.9%, OR 0.22 [p=0.034], CARTO: [+] vs [−] = 0.7% vs. 1.2%, OR 0.52 [p=0.001]). None of cryobaloon ablation, gender, type of AF, center volume, periprocedural oral anticoagulant, or left atrial diameter was significantly related with the occurrence of PE.

Conclusions: Incidence of critical PE decreased recently. HCM and primary extra-PV ablation were outstanding predictors of critical PE.

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