1. Procedure-Related Complications of Catheter Ablation for Atrial Fibrillation
- Author
-
Karim Benali, Paul Khairy, Nefissa Hammache, Adrian Petzl, Antoine Da Costa, Atul Verma, Jason G. Andrade, Laurent Macle, Université de Montréal (UdeM), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Montreal Heart Institute - Institut de Cardiologie de Montréal, McGill University Health Center [Montreal] (MUHC), Dr Benali has received grant support from the Group of Pacing and Cardiac Electrophysiology of the French Society of Cardiology. Dr Verma has received grant support, advisory board fees, and lecture fees from Bayer, Biosense Webster, and Medtronic, has received grant support from Biotronik, Bristol Myers Squibb, and Boehringer Ingelheim, has received consulting fees from Boston Scientific, MedLumics, and Thermedical, and has received lecture fees from Servier. Dr Andrade has received grant support from Baylis Medical, and and has received lecture fees from Biosense Webster. Dr Macle has received grant support and honoraria from Biosense Webster, Abbott, and Pfizer-Bristol Myers Squibb. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Subjects
meta-analysis ,trend ,catheter ablation ,adverse event ,atrial fibrillation ,complication ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,randomized trials ,Cardiology and Cardiovascular Medicine ,mortality - 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
- Published
- 2023