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Complications of Radiofrequency Catheter Ablation for Atrial Fibrillation

Radiofrequency catheter ablation (RFA) has evolved as an effective treatment modality in patients with atrial fibrillation (AF). Despite advances in RFA techniques and technology, and attempts to increase awareness and optimize management of procedural complications, there has not been a substantial decrease in complication rates over the last decade.  A recent survey conducted by Cappato et al that included 20,000 atrial fibrillation ablation procedures performed between 2003 and 2006 identified major complications in 4.5% of procedures; this is not significantly decreased from the complication rate of 4.0% reported on a survey conducted by the same group between 1995 and 2002.    This lack of significant improvement is at least partly due to the higher proportion of older patients and those with significant comorbidities such as cardiomyopathy. Overall, complication rates associated with RFA of AF have been cited in the range of 3.5 – 5%. The distribution of complications has also remained similar over the last decade, with the majority consisting of cardiac tamponade, vascular complications, and thromboembolic phenomena. In this report, the incidences and outcomes of major complications associated with catheter ablation of AF as well as potential strategies for their management will be reviewed.

Credits: Timir Baman, MD; Rakesh Latchamsetty, MD; Hakan Oral, MD

Biosense Webster
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Introduction to AFib
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