TY - JOUR
T1 - Complications in pulmonary vein isolation in the Netherlands Heart Registration differ with sex and ablation technique
AU - Mol, Daniel
AU - Houterman, Saskia
AU - Balt, Jippe C.
AU - Bhagwandien, Rohit E.
AU - Blaauw, Yuri
AU - Delnoy, Peter-Paul H.
AU - van Driel, Vincent J.
AU - Driessen, Antoine H.
AU - Folkeringa, Richard J.
AU - Hassink, Rutger J.
AU - van Huysduynen, Bart Hooft
AU - Luermans, Justin G.
AU - Ouss, Alexandre J.
AU - Stevenhagen, Yorick J.
AU - van Veghel, Dennis
AU - Netherlands Heart Registration Ablation Registration Committee
AU - Westra, Sjoerd W.
AU - de Jong, Jonas S.
AU - de Groot, Joris R.
N1 - Publisher Copyright: © 2020 Published on behalf of the European Society of Cardiology. All rights reserved.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - AIMS : Pulmonary vein isolation (PVI) has become a cornerstone of the invasive treatment of atrial fibrillation. Severe complications are reported in 1-3% of patients. This study aims to compare complications and follow-up outcome of PVI in patients with atrial fibrillation.METHODS AND RESULTS : The data were extracted from the Netherlands Heart Registration. Procedural and follow-up outcomes in patients treated with conventional radiofrequency (C-RF), multielectrode phased RF (Ph-RF), or cryoballoon (CB) ablation from 2012 to 2017 were compared. Subgroup analysis was performed to identify variables associated with complications and repeat ablations. In total, 13 823 patients (69% male) were included. The reported complication incidence was 3.6%. Patients treated with C-RF developed more cardiac tamponades (C-RF 0.8% vs. Ph-RF 0.3% vs. CB 0.3%, P ≤ 0.001) and vascular complications (C-RF 1.7% vs. Ph-RF 1.2% vs. CB 1.3%, P ≤ 0.001). Ph-RF was associated with fewer bleeding complications (C-RF: 1.0% vs. Ph-RF: 0.4% vs. CB: 0.7%, P = 0.020). Phrenic nerve palsy mainly occurred in patients treated with CB (C-RF: 0.1% vs. Ph-RF: 0.2% vs. CB: 1.5%, P ≤ 0.001). In total, 18.4% of patients were referred for repeat ablation within 1 year. Female sex, age, and CHA2DS2-VASc were independent risk factors for cardiac tamponade and bleeding complications, with an adjusted OR for female patients of 2.97 (95% CI 1.98-4.45) and 2.02 (95% CI 1.03-4.00) respectively.CONCLUSION : The reported complication rate during PVI was low. Patients treated with C-RF ablation were more likely to develop cardiac tamponades and vascular complications. Female sex was associated with more cardiac tamponade and bleeding complications.
AB - AIMS : Pulmonary vein isolation (PVI) has become a cornerstone of the invasive treatment of atrial fibrillation. Severe complications are reported in 1-3% of patients. This study aims to compare complications and follow-up outcome of PVI in patients with atrial fibrillation.METHODS AND RESULTS : The data were extracted from the Netherlands Heart Registration. Procedural and follow-up outcomes in patients treated with conventional radiofrequency (C-RF), multielectrode phased RF (Ph-RF), or cryoballoon (CB) ablation from 2012 to 2017 were compared. Subgroup analysis was performed to identify variables associated with complications and repeat ablations. In total, 13 823 patients (69% male) were included. The reported complication incidence was 3.6%. Patients treated with C-RF developed more cardiac tamponades (C-RF 0.8% vs. Ph-RF 0.3% vs. CB 0.3%, P ≤ 0.001) and vascular complications (C-RF 1.7% vs. Ph-RF 1.2% vs. CB 1.3%, P ≤ 0.001). Ph-RF was associated with fewer bleeding complications (C-RF: 1.0% vs. Ph-RF: 0.4% vs. CB: 0.7%, P = 0.020). Phrenic nerve palsy mainly occurred in patients treated with CB (C-RF: 0.1% vs. Ph-RF: 0.2% vs. CB: 1.5%, P ≤ 0.001). In total, 18.4% of patients were referred for repeat ablation within 1 year. Female sex, age, and CHA2DS2-VASc were independent risk factors for cardiac tamponade and bleeding complications, with an adjusted OR for female patients of 2.97 (95% CI 1.98-4.45) and 2.02 (95% CI 1.03-4.00) respectively.CONCLUSION : The reported complication rate during PVI was low. Patients treated with C-RF ablation were more likely to develop cardiac tamponades and vascular complications. Female sex was associated with more cardiac tamponade and bleeding complications.
KW - Atrial fibrillation
KW - Conventional radiofrequency ablation
KW - Cryoballoon
KW - Multielectrode phased radiofrequency ablation
KW - Pulmonary vein isolation
UR - http://www.scopus.com/inward/record.url?scp=85102090653&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/europace/euaa255
DO - https://doi.org/10.1093/europace/euaa255
M3 - Article
C2 - 33141152
SN - 1099-5129
VL - 23
SP - 216
EP - 225
JO - Europace : European pacing, arrhythmias, and cardiac electrophysiology
JF - Europace : European pacing, arrhythmias, and cardiac electrophysiology
IS - 2
ER -