Abstract 12609: Intracardiac Echo Findings Post Atrial Fibrillation Ablation Are an Important Predictor of Late Pericardial Effusion
Introduction: Major bleeding are serious complications of catheter ablation for atrial fibrillation (AF). Late effusions following AF ablation procedures have been recently reported.
We sought to determine whether the presence of a trivial effusion detected by intracardiac echo at the end of AF ablation procedures performed without warfarin discontinuation predicts the development of late pericardial effusion.
Methods: A total of 2618 consecutive patients undergoing catheter ablation for AF with continuous warfarin have been enrolled in this prospective registry. All ablation procedures were performed under intracardiac echocardiography (ICE) guidance. At the end of each procedure ICE was utilized to detect any degree of effusions.
Results: In 510 out of 2618 (19%) patients, trivial pericardial effusion was detected by ICE at the end of the procedure. All 2108 patients with negative ICE did not show any late pericardial effusions. On the other hand, 8 of the 510 (1.5%) patients with trivial effusion developed late significant pericardial effusion requiring pericardial drainage. The incidence of delayed effusion was 0.31% in this series. In none of the patients requiring epicardial drainage, warfarin was discontinued. A negative ICE finding for trivial pericardial effusion had a negative predictive value (NPV) of 99.6%.
Conclusion: This study shows that the presence of trivial pericardial effusion detected at the end of the ablation procedure by ICE warrant further follow-up by echocardiogram to exclude late tamponade. On the other hand, the absence of any effusion by ICE has a very high negative predictive value for late effusion.
Author Disclosures: L. Di Biase: Honoraria; Modest; Biotronik, AtriCure Inc., EpiEP.. Consultant/Advisory Board; Modest; St. Jude Medical, Biosense Webster, Inc., Hansen Medical. J. Burkhardt: None. P. Santangeli: None. P. Mohanty: None. S. Mohanty: None. C. Trivedi: None. J. Sanchez: None. R. Horton: None. P. Hranitzky: None. A. Al-Ahmad: None. G. Gallinghouse: None. S. Themistoclakis: None. R. Bai: None. J. Zagrodzky: None. D. Lakkireddy: None. M. Reddy: None. R. Hongo: None. S. Hao: None. S. Beheiry: None. M. Narducci: None. C. Elayi: None. G. Forleo: None. G. Pelargonio: None. A. Dello Russo: None. M. Casella: None. C. Tondo: None. R. Schweikert: None. A. Natale: Speakers Bureau; Modest; Medtronic, Inc., Biotronik, Boston Scientific Corp.. Honoraria; Modest; Janssen Pharmaceuticals, Biosense Webster, Inc., St. Jude Medical..
- © 2014 by American Heart Association, Inc.