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Influence of steroid therapy on the incidence of pericarditis and atrial fibrillation after percutaneous epicardial mapping and ablation for ventricular tachycardia.
- Source :
-
Circulation. Arrhythmia and electrophysiology [Circ Arrhythm Electrophysiol] 2014 Aug; Vol. 7 (4), pp. 671-6. Date of Electronic Publication: 2014 Jun 26. - Publication Year :
- 2014
-
Abstract
- Background: This study evaluates the influence of 3 therapeutic approaches on the incidence of pericarditis and atrial fibrillation (AF) after percutaneous epicardial mapping and ablation for ventricular tachycardia.<br />Methods and Results: Eighty-five consecutive procedures (2006-2011) were retrospectively reviewed. After the first 17 procedures (20.0%), no steroids were administered. For the subsequent 30 procedures (35.3%), systemic steroids were administered intravenously or orally, whereas the last 38 procedures (44.7%) were followed by intrapericardial steroid injection. Compared with no steroids, the incidence of pericarditic chest pain was significantly reduced by intrapericardial steroids (58.8% versus 21.1%; P=0.006) but not by intravenous or oral steroids (58.8% versus 43.4%; P=0.31). There was no significant difference in the incidence of pericarditic ECG with steroids (36.8%, 30.0%, and 41.2% for intrapericardial, intravenous or oral, and none, respectively). There was a nonsignificant reduced incidence of chest pain with ECG changes with steroids (13.2%, 10.0%, and 29.4% for intrapericardial, intravenous or oral, and none, respectively). Radiofrequency applications (65.9% of procedures) did not affect the incidence of pericarditic ECG changes, pericarditic chest pain, or pericarditis (all P>0.05). In 7 (8.3%) patients with no prior history of AF, AF was documented a median 36 hours after procedure. Patients with pericarditic ECG tended to be at greater risk of AF (16.7 versus 3.6%; P=0.091).<br />Conclusions: There is a high incidence of pericarditic chest pain and ECG changes after epicardial ventricular tachycardia mapping and ablation. Pericarditic chest pain is significantly decreased by intrapericardial steroids. Procedure-related AF is relatively frequent and tends to occur more commonly with pericarditic ECG changes.<br /> (© 2014 American Heart Association, Inc.)
- Subjects :
- Administration, Intravenous
Administration, Oral
Adult
Aged
Atrial Fibrillation diagnosis
Atrial Fibrillation epidemiology
Chest Pain epidemiology
Chest Pain prevention & control
Electrocardiography
Female
Humans
Incidence
Male
Middle Aged
Pericarditis diagnosis
Pericarditis epidemiology
Predictive Value of Tests
Retrospective Studies
Risk Factors
Tachycardia, Ventricular diagnosis
Tachycardia, Ventricular epidemiology
Time Factors
Treatment Outcome
Anti-Inflammatory Agents administration & dosage
Atrial Fibrillation prevention & control
Catheter Ablation adverse effects
Epicardial Mapping adverse effects
Pericarditis prevention & control
Steroids administration & dosage
Tachycardia, Ventricular surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1941-3084
- Volume :
- 7
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Circulation. Arrhythmia and electrophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 24970295
- Full Text :
- https://doi.org/10.1161/CIRCEP.113.001148