Abstract 14189: Delayed Cardiac Tamponade Following Catheter Ablation of Atrial Fibrillation With and Without Warfarin Discontinuation: Single Center Experience
Introduction: Cardiac tamponade is a worrisome peri-procedural complication of percutaneous catheter ablation of atrial fibrillation. In rare cases, delayed tamponade may occur following catheter ablation of AF. We sought to evaluate differences in the prevalence of delayed tamponade when comparing patients undergoing the ablation with warfarin discontinuation bridged with low weight heparin 0.5 mg/kg bid and patients without warfarin discontinuation.
Methods: 2201 consecutive patients undergoing catheter ablation for AF have been prospectively collected and divided into two groups. Group 1 (699 pts) underwent the procedure with warfarin discontinuation bridged with low weight heparin 0.5 mg/kg bid while group 2 (1502 pts) underwent the ablation without warfarin discontinuation. In all cases the ACT level were maintained above 300 sec and protamine was used at the end of the procedure to reverse the heparin effect. Cases of delayed tamponade were collected. Delayed tamponade was defined as any pericardial effusion requiring drainage occurring from 6 hours to two months following the index procedure.
Results: Baseline clinical and procedural characteristics were not different between the 2 groups in term of sex, age, heart failure, type of AF and CHADS2 score. Three delayed tamponade occurred in group 1 (0.4%) and 3 occurred in group 2 (0.2%) ( p= 0.336). All patients were successfully treated by percutaneous drainage. No deaths occurred in the patients with late tamponade at follow-up.
Conclusion: The prevalence of delayed cardiac tamponade following AF ablation is rare and it is not different between patients undergoing ablation with and without warfarin discontinuation.
- © 2011 by American Heart Association, Inc.