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Procedure-Related Complications of Catheter Ablation for Atrial Fibrillation
- Source :
- Journal of the American College of Cardiology, Journal of the American College of Cardiology, 2023, 81 (21), pp.2089-2099. ⟨10.1016/j.jacc.2023.03.418⟩
- Publication Year :
- 2023
- Publisher :
- HAL CCSD, 2023.
-
Abstract
- International audience; Background: Catheter ablation of atrial fibrillation (AF) is a commonly performed procedure. However, it is associated with potentially significant complications. Reported procedure–related complication rates are highly variable, depending in part on study design. Objectives: The purpose of this systematic review and pooled analysis was to determine the rate of procedure-related complications associated with catheter ablation of AF using data from randomized control trials and to assess temporal trends. Methods: MEDLINE and EMBASE databases were searched from January 2013 to September 2022 for randomized control trials that included patients undergoing a first ablation procedure of AF using either radiofrequency or cryoballoon (PROSPERO, CRD42022370273). Results: A total of 1,468 references were retrieved, of which 89 studies met inclusion criteria. A total of 15,701 patients were included in the current analysis. Overall and severe procedure-related complication rates were 4.51% (95% CI: 3.76%-5.32%) and 2.44% (95% CI: 1.98%-2.93%), respectively. Vascular complications were the most frequent type of complication (1.31%). The next most common complications were pericardial effusion/tamponade (0.78%) and stroke/transient ischemic attack (0.17%). The procedure-related complication rate during the most recent 5-year period of publication was significantly lower than during the earlier 5-year period (3.77% vs 5.31%; P = 0.043). The pooled mortality rate was stable over the 2 time periods (0.06% vs 0.05%; P = 0.892). There was no significant difference in complication rate according to pattern of AF, ablation modality, or ablation strategies beyond pulmonary vein isolation. Conclusions: Procedure-related complications and mortality rates associated with catheter ablation of AF are low and have declined in the past decade. © 2023 American College of Cardiology Foundation
Details
- Language :
- English
- ISSN :
- 07351097 and 15583597
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology, Journal of the American College of Cardiology, 2023, 81 (21), pp.2089-2099. ⟨10.1016/j.jacc.2023.03.418⟩
- Accession number :
- edsair.doi.dedup.....8991d8f01387b451a574930764a1f77b