Pericarditis following left atrial ablation

Area of Science:

• Cardiology
• Electrophysiology
• Medical Research

Background:

• Acute pericarditis is a potential complication following cardiac ablation procedures.
• Cardioneuroablation (CNA) targets the autonomic nervous system for vasovagal syncope.
• Atrial fibrillation (AF) ablation, including pulmonary vein isolation (PVI) and posterior wall isolation (PWI), is a common treatment for AF.

Purpose of the Study:

• To determine the incidence of acute pericarditis after CNA.
• To compare the risk of pericarditis in CNA patients versus those undergoing AF ablation (PVI and PWI).

Main Methods:

• A single-center prospective study involving 42 patients undergoing CNA, 46 undergoing PVI for paroxysmal AF, and 22 undergoing PVI+PWI for persistent AF.
• Incidence of pericarditis was recorded and compared across the three groups.
• Univariable logistic regression analysis was used to assess risk factors.

Main Results:

• Overall pericarditis incidence was 16.4% (18/110 patients).
• CNA group had a significantly lower pericarditis rate (2.4%, 1/42) compared to PVI (17.4%, 8/46) and PVI+PWI (40.9%, 9/22) groups (p < .001).
• CNA was associated with a lower risk of pericarditis (OR 0.11), while PVI+PWI increased the risk compared to PVI (OR 3.29).

Conclusions:

• Pericarditis is uncommon after CNA for vasovagal syncope.
• CNA is associated with a significantly lower risk of pericarditis compared to AF ablation procedures.
• The reduced risk is likely due to the less extensive left atrial ablation required for CNA.