title: Complications in the setting of percutaneous atrial fibrillation ablation using radiofrequency and cryoballoon techniques: A single-center study in a large cohort of patients.
abstract: BACKGROUND
  The aim of this study was to assess the overall incidence of complications in a large sample of consecutive patients having undergone pulmonary vein (PV) isolation, evaluating also the rate of complications in radiofrequency (RF) and cryoballoon (CB) ablation technologies.
  
  
  RESULTS
  From January 2008 to December 2014, 1352 consecutive PV isolation procedures were performed in our center; a total amount of 1233 AF ablation procedures fulfilling inclusion criteria was finally taken into consideration for our analysis. A total of 642 procedures were performed using RF ablation technology and 591 using CB system. Serious adverse events occurred in 36 procedures (2.9%): specifically, vascular complications in 14 (1.1%); cardiac tamponade in 13 (1.0%); a thromboembolic event in 4 (0.3%); and atrial-esophageal fistula, PV intramural hematoma, retroperitoneal hematoma, pleural hematoma and persisting phrenic nerve palsy all occurred in 1 patient individually (0.1%). No deaths related to the procedure occurred. The complication rate did not significantly differ in the RF and CB groups (respectively, 3.6% vs 2.2%; p=0.1). Complication rates considerably decreased over the study period from 4.67% in 2008 to 1.55% in 2014. Interestingly, each 1-point increase in the CHA2DS2-VASc score was found to increase by 51% the likelihood of a serious adverse event.
  
  
  CONCLUSIONS
  The incidence of serious adverse events following AF ablation procedures was 2.9%. Vascular complications were the most frequent complication followed by tamponade and thromboembolic events. The rate of complications considerably decreased over time. CHA2DS2-VASc score was found to be associated with higher risk of complications.
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium. Electronic address: mugnai.giacomo@gmail.com.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Mugnai
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Ghazala
authors.initials: G
authors.lastname: Irfan
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Carlo
authors.initials: C
authors.lastname: de Asmundis
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ciconte
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saitoh
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Burak
authors.initials: B
authors.lastname: Hunuk
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Vedran
authors.initials: V
authors.lastname: Velagic
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Erwin
authors.initials: E
authors.lastname: Stroker
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Paolo
authors.initials: P
authors.lastname: Rossi
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Lucio
authors.initials: L
authors.lastname: Capulzini
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
authors.affiliation: Heart Rhythm Management Centre, UZ Brussel-VUB, Brussels, Belgium.
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology*; D001164:Arteriovenous Fistula / Q000175:diagnosis / Q000209:etiology*; D001281:Atrial Fibrillation / Q000601:surgery*; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000209:etiology*; D017115:Catheter Ablation / Q000009:adverse effects*; D003452:Cryosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology*
keywords: Atrial fibrillation; Complications; Cryoballoon; Radiofrequency