Outcome of cardiac tamponades in interventional electrophysiology
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Outcome of cardiac tamponades in interventional electrophysiology. / Fink, Thomas; Sciacca, Vanessa; Feickert, Sebastian; Metzner, Andreas; Lin, Tina; Schlüter, Michael; Tilz, Roland Richard; Heeger, Christian-Hendrik; Maurer, Tilman; Reissmann, Bruno; Rottner, Laura; Mathew, Shibu; Wohlmuth, Peter; Ouyang, Feifan; Kuck, Karl-Heinz; Rillig, Andreas.
In: EUROPACE, Vol. 22, No. 8, 01.08.2020, p. 1240-1251.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Outcome of cardiac tamponades in interventional electrophysiology
AU - Fink, Thomas
AU - Sciacca, Vanessa
AU - Feickert, Sebastian
AU - Metzner, Andreas
AU - Lin, Tina
AU - Schlüter, Michael
AU - Tilz, Roland Richard
AU - Heeger, Christian-Hendrik
AU - Maurer, Tilman
AU - Reissmann, Bruno
AU - Rottner, Laura
AU - Mathew, Shibu
AU - Wohlmuth, Peter
AU - Ouyang, Feifan
AU - Kuck, Karl-Heinz
AU - Rillig, Andreas
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.
PY - 2020/8/1
Y1 - 2020/8/1
N2 - AIMS: The aim of this study was to analyse tamponades following electrophysiological procedures regarding frequency and mortality in a high-volume centre and to identify independent predictors for severe tamponades.METHODS AND RESULTS: We performed a retrospective study on 34 982 consecutive patients undergoing diagnostic electrophysiological studies or catheter ablation of cardiac arrhythmias. The combined endpoint was defined as severe tamponade. Criteria for severe tamponade included surgical repair, repeat pericardiocentesis, cardiopulmonary resuscitation, intrahospital death or death during follow-up, and thrombo-embolic events or complications due to therapeutic management. Multivariate analysis was performed to identify independent predictors for severe tamponade. A total of 226 tamponades were identified. Overall frequency of tamponades was 0.6%. Procedures requiring epicardial approach had the highest rate of tamponades (9.4%). Twenty-nine patients with tamponade underwent surgery (12.8% of all tamponades and 21.4% of tamponades during epicardial procedures). Overall tamponade-related mortality was 0.03% (9 deaths). Fifty-six patients (24.8%) experienced severe tamponade. Independent risk factors for severe tamponades were endocardial ablation of ventricular tachycardia, epicardial approach, balloon device ablation, high aspiration volume during pericardiocentesis and structural heart disease.CONCLUSION: The frequency of tamponades is strongly dependent on the type of procedure performed. Overall tamponade-related mortality was low but significantly higher in patients undergoing epicardial procedures. Surgical backup should be considered for patients undergoing complex ventricular tachycardia ablation and left atrial ablation procedures.
AB - AIMS: The aim of this study was to analyse tamponades following electrophysiological procedures regarding frequency and mortality in a high-volume centre and to identify independent predictors for severe tamponades.METHODS AND RESULTS: We performed a retrospective study on 34 982 consecutive patients undergoing diagnostic electrophysiological studies or catheter ablation of cardiac arrhythmias. The combined endpoint was defined as severe tamponade. Criteria for severe tamponade included surgical repair, repeat pericardiocentesis, cardiopulmonary resuscitation, intrahospital death or death during follow-up, and thrombo-embolic events or complications due to therapeutic management. Multivariate analysis was performed to identify independent predictors for severe tamponade. A total of 226 tamponades were identified. Overall frequency of tamponades was 0.6%. Procedures requiring epicardial approach had the highest rate of tamponades (9.4%). Twenty-nine patients with tamponade underwent surgery (12.8% of all tamponades and 21.4% of tamponades during epicardial procedures). Overall tamponade-related mortality was 0.03% (9 deaths). Fifty-six patients (24.8%) experienced severe tamponade. Independent risk factors for severe tamponades were endocardial ablation of ventricular tachycardia, epicardial approach, balloon device ablation, high aspiration volume during pericardiocentesis and structural heart disease.CONCLUSION: The frequency of tamponades is strongly dependent on the type of procedure performed. Overall tamponade-related mortality was low but significantly higher in patients undergoing epicardial procedures. Surgical backup should be considered for patients undergoing complex ventricular tachycardia ablation and left atrial ablation procedures.
KW - Cardiac Electrophysiology
KW - Cardiac Tamponade/diagnosis
KW - Catheter Ablation/adverse effects
KW - Humans
KW - Pericardiocentesis/adverse effects
KW - Retrospective Studies
KW - Treatment Outcome
U2 - 10.1093/europace/euaa080
DO - 10.1093/europace/euaa080
M3 - SCORING: Journal article
C2 - 32500141
VL - 22
SP - 1240
EP - 1251
JO - EUROPACE
JF - EUROPACE
SN - 1099-5129
IS - 8
ER -
