title: Prevalence and predictors of complications of radiofrequency catheter ablation for atrial fibrillation.
abstract: BACKGROUND
  Up to 6% of patients experience complications after radiofrequency catheter ablation (RFA) of atrial fibrillation (AF). The purpose of this study is to determine the prevalence and predictors of periprocedural complications after RFA for AF.
  
  
  RESULTS
  The subjects were 1,295 consecutive patients (age = 60 ± 10 years) who underwent RFA (n = 1,642) for paroxysmal (53%) or persistent AF (47%) from January 2007 to January 2010. A complication occurred in 57 patients (3.5%); a vascular access complication in 31 (1.9%); pericardial tamponade in 20 (1.2%); a thromboembolic event in 4 (0.2%); deep venous thrombosis in 1 (<0.01%); and pulmonary vein stenosis in 1 patient (<0.01%). There were no procedure-related deaths. On multivariate analysis, female gender (OR = 2.27; ±95% CI: 1.31-2.57, P < 0.01) and procedures performed in July or August (OR = 2.10; ±95% CI: 1.16-3.80, P = 0.01) were independent predictors of any complication. For vascular complications, treatment with clopidogrel (OR = 4.40; ±95% CI: 1.43-13.53, P = 0.01), female gender (OR = 3.65; ±95% CI: 1.72-7.75, P < 0.01) and performing RFA in July or August (OR = 2.71; ±95% CI: 1.25-5.87, P = 0.01) were independent predictors. The only predictor of cardiac tamponade was prior RFA (OR = 3.32; ±95% CI: 0.95-11.61; P < 0.05).
  
  
  CONCLUSIONS
  Prevalence of perioperative complications for RFA of AF is 3.5% and vascular access complications constitute the majority. The need for clopidogrel therapy should be carefully considered prior to RFA. At teaching institutions close supervision should be exercised during vascular access early in the year. Improvements in ablation technology and elimination of the need for repeat procedures may decrease the risk of pericardial tamponade.
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Timir S
authors.initials: TS
authors.lastname: Baman
authors.forename: Krit
authors.initials: K
authors.lastname: Jongnarangsin
authors.forename: Aman
authors.initials: A
authors.lastname: Chugh
authors.forename: Arisara
authors.initials: A
authors.lastname: Suwanagool
authors.forename: Aurelie
authors.initials: A
authors.lastname: Guiot
authors.forename: Arin
authors.initials: A
authors.lastname: Madenci
authors.forename: Spencer
authors.initials: S
authors.lastname: Walsh
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Ilg
authors.forename: Sanjaya K
authors.initials: SK
authors.lastname: Gupta
authors.forename: Rakesh
authors.initials: R
authors.lastname: Latchamsetty
authors.forename: Suveer
authors.initials: S
authors.lastname: Bagwe
authors.forename: James D
authors.initials: JD
authors.lastname: Myles
authors.forename: Thomas
authors.initials: T
authors.lastname: Crawford
authors.forename: Eric
authors.initials: E
authors.lastname: Good
authors.forename: Frank
authors.initials: F
authors.lastname: Bogun
authors.forename: Frank
authors.initials: F
authors.lastname: Pelosi
authors.forename: Fred
authors.initials: F
authors.lastname: Morady
authors.forename: Hakan
authors.initials: H
authors.lastname: Oral
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors