Safety of fluoroless radiofrequency catheter ablation for atrial fibrillation in patients with pre-existing cardiac implantable electronic device: A single-center study.
Pacing Clin Electrophysiol
; 46(11): 1387-1392, 2023 11.
Article
em En
| MEDLINE
| ID: mdl-37713192
ABSTRACT
BACKGROUND:
Radiofrequency catheter ablation (RFA) for atrial fibrillation (AF) is being increasingly performed without fluoroscopy. This study aims to determine the safety of fluoroless RFA for patients with pre-existing cardiac implantable electronic devices (CIED).METHODS:
This is a single-center, single-operator, retrospective, observational study of 225 consecutive fluoroless RFA procedures for AF from June 1, 2019 to June 1, 2022. All procedures were performed with intracardiac echocardiography (ICE) support. Patients with pre-existing CIED were extracted from the database. Each CIED was interrogated at the start and end of each procedure and at 30-day follow-up. Pre- and post-procedure CIED interrogations were compared for any change in device or lead parameters. Patients were tracked for any subsequent device malfunction.RESULTS:
Out of 225 fluoroless AF ablations, 25 (10.2%) had pre-existing CIED (14 dual-chamber pacemakers, three dual-chamber defibrillators, three single-chamber defibrillators, one single chamber pacemaker, and four biventricular devices). Mean patient age was 71 ± 6 years. The mean duration of indwelling CIED was 1804 ± 1645 days (range 78-6267 days). One (4%) patient had lead-related fibrin on ICE imaging. There was no significant difference in lead(s) threshold, impedance, or sensing post procedure or at 30-day follow-up compared to pre procedure. None of the patients required lead revision. There were no intra- or post-op thromboembolic events or subsequent device infection. One patient underwent CIED extraction after 11 months for an unrelated secondary device infection.CONCLUSIONS:
Radiofrequency catheter ablation for AF can be safely performed without fluoroscopy in patients with pre-existing CIED.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Desfibriladores Implantáveis
/
Ablação por Cateter
Tipo de estudo:
Observational_studies
Limite:
Aged
/
Humans
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos