title: Clinical and procedural predictors of early complications of ablation for atrial fibrillation: analysis of the national registry data.
abstract: BACKGROUND
  The risk assessment of the complication from atrial fibrillation (AF) ablation is important and needs to be updated.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the clinical and procedural factors associated with AF ablation-related early complications.
  
  
  METHODS
  The Japanese Heart Rhythm Society invited electrophysiology centers in Japan to register data regarding all AF ablation procedures performed in September 2011, March 2012, and September 2012. Of the 46 putative predictors assessed in the univariate analysis, significant variables (P < .1) were entered into a stepwise logistic regression model for multivariate analysis.
  
  
  RESULTS
  Data for 3373 cases were submitted by 165 centers, with 158 early complications reported in 151 patients (4.5%). We identified 13 significant variables in the univariate analysis. Multivariate analysis revealed that 8 (62%) of them were independent predictors of early complications. Female sex (odds ratio and 95% confidence interval 1.6; 1.13-2.27), hypertrophic cardiomyopathy (2.2; 1.08-4.5), valvular heart disease (2.53; 1.28-5.05), deep sedation during the procedure (1.53; 1.09-2.12), and complex fractionated atrial electrocardiogram ablation (1.88; 1.23-2.87) increased early complications. Preprocedural transesophageal echocardiography (0.63; 0.43-0.92), irrigated-tip catheter use (0.46; 0.3-0.69), and periprocedural novel oral anticoagulant use (0.55; 0.32-0.97) decreased them.
  
  
  CONCLUSIONS
  The risk of early complications is increased by female sex, hypertrophic cardiomyopathy, valvular heart disease, deep sedation, and complex fractionated atrial electrocardiogram ablation. It is decreased by preprocedural transesophageal echocardiography, periprocedural novel oral anticoagulant, and irrigated-tip catheter use.
authors.affiliation: Cardiovascular Center, Sakurabashi Watanabe Hospital, Osaka, Japan. Electronic address: koichi@inoue.name.
authors.forename: Koichi
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Fourth Department of Internal Medicine, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Murakawa
authors.affiliation: Cardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Nogami
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Morio
authors.initials: M
authors.lastname: Shoda
authors.affiliation: Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Naito
authors.affiliation: Heart Rhythm Center, Fukuoka Sanno Hospital, Fukuoka, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kumagai
authors.affiliation: Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Miyauchi
authors.affiliation: Department of Cardiology, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Teiichi
authors.initials: T
authors.lastname: Yamane
authors.affiliation: Division of Cardiology, Department of Medicine, Tokai University Hachioji Hospital, Hachioji, Japan.
authors.forename: Norishige
authors.initials: N
authors.lastname: Morita
authors.affiliation: Division of Cardiology, Hirosaki University of Graduate School of Medicine, Hirosaki, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Okumura
mesh_terms: D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods; D016208:Databases, Factual; D017548:Echocardiography, Transesophageal / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology; D011237:Predictive Value of Tests; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants
keywords: Atrial fibrillation; Catheter ablation; Complication; Deep sedation; Novel oral anticoagulant