Techniques to Avoid Complications of Atrial Fibrillation Ablation
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(2020) 22:31
Arrhythmia (R Kabra, Section Editor)
Techniques to Avoid Complications of Atrial Fibrillation Ablation Nachiket M. Apte, MBBS Amit Shreshta, MBBS Raghuveer Dendi, MD* Address * The Department of Cardiovascular Medicine, University of Kansas Medical Center, Medical Office Pavilion, 5th Floor, Suite 5200, Mailstop 1032, Kansas City, KS, 66160, USA Email: [email protected]
* Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Arrhythmia Keywords Atrial fibrillation ablation I Techniques I Complications
Abstract Purpose of review Atrial fibrillation ablation is an increasingly common procedure adapted by electrophysiologists across the world. Any procedure naturally comes with inherent risks of complications. The goal of this review is to elaborate latest techniques and strategies to avoid complications of ablation. Recent findings There is increased focus on new tools for avoiding esophageal injury as well as minimizing phrenic nerve injury in addition to utilization of newer ablation technologies to address safer and effective ablation. Summary A combination of improved patient selection and better treatment protocols combined with methods for early detection of complications will significantly reduce the incidence of complications. Newer innovative technologies like esophageal temperature monitoring, mechanical deviation, and integration of ablation parameters are helping to avoid or minimize collateral damage.
Introduction Atrial fibrillation (AF) is the most common age-related tachyarrhythmia encountered in clinical practice [1••]. The improvement in overall survival in the population and improved management of cardiovascular disease
have resulted in an observed increase in the incidence of AF especially in the population aged 65 years and above. It is associated with increased morbidity as well as mortality due to its association with ischemic stroke, dementia,
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Curr Treat Options Cardio Med
heart failure, and cardiomyopathy. Over the last 30 years, pulmonary vein isolation (PVI) involving the blockade of potential pulmonary vein triggers in the left atrium (LA) by catheter ablation has become the mainstay of treatment for patients who are candidates for rhythm control, and those who cannot tolerate antiarrhythmic agents. Though radiofrequency (RF) ablation has been the most widely used mode of ablation since the 1990s, newer techniques like cryoablation, laser balloon ablation, and, more recently, pulsed field ablation have been introduced as alternatives to achieve durable lesions.
(2020) 22:31
Ablation for AF has been associated with major and minor complications which continue to persist despite significant reduction in their incidence over the last 30 years [2–9]. A combination of improved patient selection, better treatment protocols, and methods for early detection of complications has significantly reduced the incidence of major and minor complications. In this article, we attempt to identify the follo
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