Acute pericarditis following second-generation cryoballoon ablation for atrial fibrillation
- 22 Downloads
Acute pericarditis is a minor complication following atrial fibrillation (AF) ablation procedures. The aim of the study was to evaluate the incidence and clinical aspects of pericarditis following cryoballoon (CB) ablation of AF investigating a possible association with procedural characteristics and a possible relationship with post-ablation recurrences.
Four hundred fifty consecutive patients (male 73%, age 59.9 ± 11.2 years) with drug-resistant paroxysmal AF who underwent CB ablation as index procedure were enrolled. Exclusion criteria were any contraindication for the procedure including the presence of intracavitary thrombus and uncontrolled heart failure and contraindications to general anesthesia.
Acute pericarditis following CB ablation occurred in 18 patients (4%) of our study population. Pericardial effusion occurred in 14 patients (78%) and was mild/moderate. The total number of cryoapplications and the total freeze duration were significantly higher in patients with pericarditis compared with those without (respectively, p = 0.0006 and p = 0.01). Specifically, the number of applications and freeze duration in right inferior pulmonary vein were found significantly higher in patients with pericarditis (p = 0.007). The recurrence rate did not significantly differ between the two study groups (respectively, 16.7 vs 18.1%; p = 0.9).
The incidence of acute pericarditis following CB ablation in our study population accounted for 4% and was associated with both total freezing time and number of cryoapplications. The clinical course was favorable in all these patients and the occurrence of acute pericarditis did not affect the outcome during the follow-up period.
KeywordsAtrial fibrillation Cryoballoon Pericarditis Ablation Pulmonary vein isolation
Compliance with ethical standards
The protocol was carried out in accordance with the ethical principles for medical research involving human subjects established by the Declaration of Helsinki protecting the privacy of all participants as well as the confidentiality of their personal information. The study was approved by the ethics committee.
Conflicts of interest
GBC and CdA receive compensation for teaching purposes and proctoring from AF solutions, Medtronic. PB receives research grants on behalf of the center from Biotronik, Medtronic, St. Jude Medical, Sorin, and Boston Scientific and speaker’s fees from Biosense-Webster, Biotronik, and Medtronic. CdA is consultant for Daiichi Sankyo. GM received an educational grant from Medtronic for Postgraduate in Cardiac Electrophysiology and Pacing academic course.
- 4.Fürnkranz A, Bordignon S, Dugo D, Perotta L, Gunawardene M, Schulte-Hahn B, et al. Improved 1-year clinical success rate of pulmonary vein isolation with the second-generation cryoballoon in patients with paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol. 2014;25:840–4.CrossRefPubMedGoogle Scholar
- 6.Mugnai G, de Asmundis C, Iacopino S, Stroker E, Longobardi M, De Regibus V, et al. Comparison of the incidences of complications after second-generation cryoballoon ablation of atrial fibrillation using vitamin K antagonists versus novel oral anticoagulants. Am J Cardiol. 2017;120:223–9.CrossRefPubMedGoogle Scholar
- 8.Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J, et al. 2015 ESC guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC) Endorsed by: the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36:2921–64.CrossRefPubMedGoogle Scholar