Abstract 15108: Outcomes in Patients With Pericardial Effusion Requiring Drainage After Electrophysiology Procedures
Background: Pericardial effusion (PE) is a known complication of electrophysiological procedures (EPP). We sought to describe patient characteristics and outcomes in PE requiring drainage after EPP.
Methods: We identified 114 patients who underwent EPP at our center from 2000 to 2012 and had an intervention for new pericardial effusion up to 1 month after the EPP. Baseline demographic and clinical data were recorded. Primary outcome was 30 days mortality after PE drainage. Secondary outcome was major bleeding (drop in hemoglobin ≥ 3 gm/dl or requiring blood transfusion) after PE drainage.
Results: Mean age was 65±13 years (48% men). Mean ejection fraction (EF) was 53±12. Hypertension and diabetes mellitus were found in 54 and 49%. Heart failure (HF) and coronary artery disease were present in 26 and 27%. Dual antiplatelet therapy was used in 6.7%, while combined Aspirin, Clopidogrel and oral anticoagulant was used in 1.7%. Intra-procedural heparin was used in 62%. Presenting symptoms were chest pain, shortness of breath and altered mental status in 51, 42 and 26%. Pulmonary vein isolation was done in 50% while pacemaker insertion and ventricular tachycardia ablation were done in 8.8 and 9.7%. Drainage of PE was done by emergent and elective pericardiocentesis in 65 and 28% while elective pericardial window and emergent sternotomy for exploration was done in 2.6 and 4.4%. Re-accumulation occurred in 12.3% and a second intervention was required in 57% of those patients. The primary outcome occurred in 2.6% and secondary outcome occurred in 45.6%. Predictors of mortality were older age, higher drop in hemoglobin, and lower EF (all p<0.05). Predictors of secondary outcome were HF and higher INR at time of procedure (both p=<0.05).
Conclusion: Pericardial effusion after an electrophysiology procedures requiring intervention is associated with a mortality of 2.6% within 30 days. Older age, lower ejection fraction and higher drop in hemoglobin were associated with worse outcomes.
Author Disclosures: A. Mentias: None. S. Horr: None. A. El-Telbany: None. M. Kanj: None. A. Klein: None.
- © 2015 by American Heart Association, Inc.