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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Catheter ablation of complex cardiac arrhythmias: Single-centre experience in Armed Forces

Pradeep Kumar Hasija1, Prashant Bhardwaj2, Anup Banerji3

  • 1MG Med, HQ Dakshin Bharat Area, India.

Medical Journal, Armed Forces India
|July 26, 2021
PubMed

Insights

Radiofrequency ablation for complex arrhythmias shows comparable success rates to standard procedures. However, complex ablations involve more hardware, a higher risk of complications, and increased fluoroscopy time.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Complex arrhythmia ablation presents significant technical challenges.
  • Advances in mapping and hardware aim to improve outcomes.
  • This study analyzes the efficacy of radiofrequency ablation for complex arrhythmias at a tertiary center.

Purpose of the Study:

  • To evaluate the efficacy of radiofrequency ablation for complex arrhythmias.
  • To compare outcomes of complex ablation procedures with standard procedures.
  • To identify associated risks and resource utilization in complex ablations.

Main Methods:

  • Retrospective analysis of catheter ablations performed between August 2012 and November 2016.
  • Procedures classified as complex if involving 3D electro-anatomical (EA) mapping, special hardware, or trans-septal puncture.
  • Standard ablation used conventional catheters with conventional access routes.

Main Results:

  • Overall success rates for complex ablations were comparable to standard procedures (87.2% vs. 88.3% after first procedure; 90.4% vs. 94.7% after redo).
  • Complex procedures utilized 3D EA mapping (31%), trans-septal puncture (40%), and special hardware (100%).
  • Complications (pericardial perforation, cardioembolism) occurred in the complex group; fluoroscopy time was longer (25.10 min vs. 15.23 min).

Conclusions:

  • Complex electrophysiological procedures for arrhythmia ablation achieve success rates similar to standard procedures.
  • These complex procedures necessitate increased hardware, carry a higher risk of complications, and require longer fluoroscopy times.
  • Despite challenges, complex ablation remains a viable option for challenging arrhythmias.
Abstract

Keywords:
ArrhythmiaCatheter ablationComplex

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