Avoiding Urinary Catheterization in Patients Undergoing Atrial Fibrillation Catheter Ablation

Area of Science:

• Cardiology
• Urology
• Anesthesiology

Background:

• Indwelling urinary catheters (IUC) are frequently used during general anesthesia.
• Routine IUC insertion carries significant risks.
• The necessity of IUC during atrial fibrillation (AF) ablation is questioned.

Purpose of the Study:

• To compare urinary and other outcomes in patients undergoing AF ablation with or without IUC.
• To assess the risks associated with routine IUC insertion in this patient population.

Main Methods:

• Single-center, retrospective review of patients undergoing AF ablation.
• Data manually extracted from electronic health records.
• Primary endpoint: 7-day periprocedural urinary outcomes (cystitis, dysuria, hematuria, urethral damage, urinary retention).

Main Results:

• 404 patients: 297 with IUC, 107 without.
• No urinary complications in uncatheterized patients vs. 14 in catheterized group (P=0.026).
• 3 serious infections in uncatheterized group vs. none in catheterized (P=0.018). Uncatheterized patients had shorter procedures and less fluid administration.

Conclusions:

• No urinary complications observed in 107 patients without IUC during AF ablation.
• Avoiding bladder catheters may reduce adverse urinary events.
• This approach does not appear to increase the risk of urinary retention.