RESUMEN
PURPOSE: The aim of the present study is to evaluate the feasibility and safety of SVC electrical isolation by LB ablation in patients with atrial fibrillation (AF) referred for pulmonary vein isolation (PVI). METHODS: Electrical disconnection of the SVC was attempted by LB in 13 consecutive patients (59 ± 10.5 years, 11 male) with AF following PVI. PVI was successfully achieved by standard LB in all before attempting SVC isolation. RESULTS: A laser beam was delivered with 6.3 ± 2.3 W and 8.4 ± 2.7 W (P = 0.001) during 5.38 ± 2.4 min and 9.75 ± 1.6 min (P = 0.024) to achieve SVC and PV, respectively. Isolation of the SVC by LB was accomplished in 8 patients (61%) without complications. Phrenic nerve palsy developed in 3 patients (23%), which resulted in early procedure termination before isolation. Technical problems or interposition of a pacemaker lead to prevented SVC isolation in the remaining 2 patients. After a mean follow-up of 19 ± 3 months, no patient recovered from phrenic nerve palsy. CONCLUSIONS: SVC isolation by LB is feasible but associated with a high risk of phrenic nerve palsy. Limitation of laser delivery time and power appears insufficient to prevent this complication.
Asunto(s)
Fibrilación Atrial/cirugía , Ablación por Catéter/métodos , Terapia por Láser/métodos , Vena Cava Superior/cirugía , Adulto , Anciano , Fibrilación Atrial/diagnóstico por imagen , Estudios de Cohortes , Electrocardiografía/métodos , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tempo Operativo , Pronóstico , Venas Pulmonares/cirugía , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
Aim: To determine if performing catheter ablation under oral anticoagulation is associated with a higher risk of thromboembolic or bleeding complications. Methods: Patients with common atrial flutter that underwent catheter ablation of the cavo-tricuspid isthmus were consecutively included in the study. All patients were taking oral anticoagulants at least 3 weeks before the ablation. Results: A total of 102 patients (mean age 67.9 ± 10.3 years; 83.3% male) were included. Among them 80.6% patients were taking acenocoumarol, 10.7% dabigatran, 7.8% rivaroxaban and 0.9% apixaban. After the procedure, no new pericardial effusion or major complications were detected. In the study 7.8% of patients had mild hematoma in the puncture site. Conclusion: Performing common atrial flutter catheter ablation under oral anticoagulation is associated with low risk of complications.