Abstract 2547: Management of Pericardial Effusion During and After Ablation for Atrial Fibrillation in Patients Undergoing the Procedure With Therapeutic INR
Introduction: Pericardial effusion is a well known complication during and after catheter ablation of atrial fibrillation. The percentage reported in the literature is around 1.2%. The aim of this study is to evaluate the management of pericardial effusion in patients undergoing ablation of AF while on therapeutic Coumadin in comparison to patients discontinuing Coumadin before procedure.
Methods: 2118 pts undergoing catheter ablation of atrial fibrillation (RFCA) on Coumadin (group I) and 2488 patients undergoing RFCA of AF off Coumadin (group II) have been enrolled in this study at four different centers. Peri-procedural pericardial effusions have been prospectively collected in a data base.
Results: In group I a total of 11 pericardial effusions (0.5%) were reported. 7 were documented during the procedure and 4 occurred 1 to 4 weeks after the procedure. In group two a total of 12 (0.5%) pericardial effusions occurred (9 peri-procedural and 3 after 1– 4 weeks after the procedure). The management is reported in the table⇓.
Conclusions: Pericardial effusion, although a potentially dangerous complication of catheter ablation of atrial fibrillation, is rare and does not appear to be increased by the continuation of Coumadin therapy. Once it does occur it can be treated with conservative therapy even in pts on Coumadin. However in patients on Coumadin, more fluid is removed from the pericardial space and more units of blood are transfused.