Echocardiographic evaluation after different atrial fibrillation ablation approaches

Introduction: Atrial fibrillation (AF) ablation is increasingly being performed in electrophysiology laboratories. Pericardial effusion (PE) is certainly one of the most frequently observed complications during AF ablation. The aim of our study was to investigate the incidence and outcome of PE following cryothermal energy balloon ablation (CBA) in comparison to conventional circumferential pulmonary vein isolation with a focal radiofrequency (RF) catheter. Methods: A total of 133 (105 male) consecutive patients with paroxysmal AF were included in this study. Forty-six patients (36 male) underwent CBA (Arctic Front, Medtronic, USA) and 87 (69 male) point by point RF ablation guided by electroanatomical mapping (Carto, Biosense Webster, Diamond Bar, CA, USA). Ablation was performed under general anesthesia with both techniques. All patients underwent within 24 hours before and after the procedure a 2D transthoracic echocardiogram as routinely performed in our centre. Results: PE was detected in 19 (14,2%) of 133 patients. Sixteen patients presented mild effusion, 1 moderate effusion and 2 pericardial tamponades. There was no significant difference in the incidence of PE between the cryoballoon and the RF group (11% vs 16%). A longer procedural time, coronary artery disease and arterial hypertension were found to be independent predictors of PE during AF ablation. Conclusions: PE occurred in a similar proportion following CBA and RF ablation for AF. PE was mostly mild and asymptomatic with benign clinical outcome not requiring additional hospitalization days. (Table presented).