Analysis of thrombotic complications after catheter ablation.
BACKGROUND
Thromboembolic complications are described in about 1% of the patients undergoing radiofrequency catheter ablation (RFA). The aim of this study was to analyze thrombotic complications after RFA and to determine prothrombotic states in patients with thrombotic complications.


METHODS
We analyzed data from 400 patients (212 females) who underwent 453 RFA procedures for supraventricular tachycardias. Transthoracic echocardiography was performed one day before and after RFA in all patients. We evaluated the clinical and laboratory (in patients with thrombotic complications after RFA) risk factors of thromboembolism.


RESULTS
We observed thrombotic complication in 7 (1.75%) patients (6 females), thrice flail thrombus in the right atrium, flail thrombus in the inferior vena cava, femoral vein thrombosis with massive pulmonary embolism, femoral vein mural thrombus and upper extremity digital arteries embolization; four of them were asymptomatic. As a prothrombotic state we identified factor V Leiden mutation in one case and the use of oral contraceptives in two cases. Two other patients had a positive history of thromboembolic events. In a subgroup of females the use of oral contraceptives (p = 0.13) or a positive history of thromboembolism (p = 0.21) were not identified as important risk factors.


CONCLUSIONS
Echocardiographic detection of asymptomatic thrombotic complications contributed to the higher percentage of these complications in our study. Although we can identify the risk factor (laboratory or clinical) in a majority of patients with a thromboembolic complication, occurrence of these complications is unpredictable.
Haman
Ludĕk
L
1st Department of Internal Medicine, Charles University in Prague, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic. haman@fnhk.cz
Parízek
Petr
P
Malý
Radovan
R
Duda
Jirí
J
Malý
Jaroslav
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D013617:Tachycardia, Supraventricular / Q000601:surgery*; D013927:Thrombosis / Q000209:etiology*