title: Postprocedural neuropathy after atrial fibrillation ablation.
abstract: OBJECTIVE
  Access-related neuropathy after atrial fibrillation (AF) ablation is underappreciated. We intend to describe the incidence, management, and prognosis of postprocedural neuropathy after AF ablation.
  
  
  METHODS
  We performed a retrospective analysis of all consecutive patients with postprocedural neuropathy who underwent AF ablation in three high-volume tertiary care hospitals between January 2007 and April 2011.
  
  
  RESULTS
  Of the 3,128 patients who underwent AF ablation during the study period, 25 (0.8 %) patients had postprocedural neuropathy and were included in the current study. Mean age was 58.5 ± 11.5 years with 18 (72 %) being males and 14 (56 %) having paroxysmal AF. Ulnar nerve, lateral femoral cutaneous nerve manifesting as meralgia paresthetica, and femoral nerve were involved in 5 (20 %), 13 (54 %), and 7 (26 %) of the patients, respectively. Majority of neuropathies were associated with periprocedural hematomas (19, 76 %), and a quarter (19/72, 26 %) of all hematomas were associated with neuropathy. Initial treatment included warm and cold compresses followed by nonsteroidal anti-inflammatory and narcotic pain medications. In addition to the above regimen, in some patients (11, 44 %), oral gabapentin was used and it was associated with a shorter time to symptom resolution (9.4 vs. 14.1 days, p = 0.007). All patients were symptom free within 90 days of the procedure.
  
  
  CONCLUSIONS
  Postprocedural neuropathy after AF ablation is rare and is frequently associated with a periprocedural hematoma. Patients typically become symptom free within 90 days of the procedure, and gabapentin may have a role in earlier symptom resolution.
authors.affiliation: Center for Excellence in AF & Complex Arrhythmia, KU Cardiovascular Research Institute, Division of Cardiovascular Medicine, Mid America Cardiology-University of Kansas Hospital, Kansas City, KS 66160-7200, USA.
authors.forename: Yeruva Madhu
authors.initials: YM
authors.lastname: Reddy
authors.forename: Dhssraj
authors.initials: D
authors.lastname: Singh
authors.forename: Vineela
authors.initials: V
authors.lastname: Chikkam
authors.forename: Sudharani
authors.initials: S
authors.lastname: Bommana
authors.forename: Donita
authors.initials: D
authors.lastname: Atkins
authors.forename: Atul
authors.initials: A
authors.lastname: Verma
authors.forename: Vijay
authors.initials: V
authors.lastname: Swarup
authors.forename: Yariv
authors.initials: Y
authors.lastname: Khaykin
authors.forename: Srinivas
authors.initials: S
authors.lastname: Nalamachu
authors.forename: Mamatha
authors.initials: M
authors.lastname: Pasnoor
authors.forename: Dhanunjaya
authors.initials: D
authors.lastname: Lakkireddy
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D007615:Kansas / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D059348:Peripheral Nerve Injuries / Q000453:epidemiology*; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors