Heart Rhythm Management Centre, UZ Brussel-VUB, Laarbeeklaan 101, 1090 Brussels, Belgium.
Europace. 2010 Mar;12(3):337-41. doi: 10.1093/europace/eup422. Epub 2010 Jan 6.
Atrial fibrillation (AF) ablation is increasingly being performed in electrophysiology laboratories. Pericardial effusion (PE) is certainly one of the most frequently observed complications during AF ablation. The aim of our study was to investigate the incidence and outcome of PE following cryothermal energy balloon ablation (CBA) in comparison with conventional circumferential pulmonary vein isolation with a focal radiofrequency (RF) catheter.
A total of 133 consecutive patients (105 males) with paroxysmal AF were included in this study. Forty-six patients (36 males) underwent CBA (Arctic Front, Medtronic, USA) and 87 (69 males) point-by-point RF ablation guided by electroanatomical mapping (Carto, Biosense Webster, Diamond Bar, CA, USA). Ablation was performed under general anaesthesia with both techniques. All patients underwent a 2D transthoracic echocardiogram within 24 h before and after the procedure as routinely performed in our centre. Pericardial effusion was detected in 19 (14.2%) of 133 patients. Sixteen patients presented mild effusion, one moderate effusion, and two pericardial tamponades. There was no significant difference in the incidence of PE between the cryoballoon and the RF group (11 vs. 16%). A longer procedural time, coronary artery disease, and arterial hypertension were found to be independent predictors of PE during AF ablation.
Pericardial effusion occurred in a similar proportion following CBA and RF ablation for AF. Pericardial effusion was mostly mild and asymptomatic, with benign clinical outcome not requiring additional hospitalization days.
心房颤动（AF）消融术在电生理实验室中越来越多地进行。心包积液（PE）肯定是 AF 消融过程中观察到的最常见并发症之一。我们的研究旨在调查与使用常规环形肺静脉隔离加点状射频（RF）导管相比，冷冻球囊消融（CBA）后心包积液的发生率和结果。
本研究共纳入 133 例阵发性 AF 连续患者（105 例男性）。46 例患者（36 例男性）接受 CBA（北极前线，美敦力，美国）治疗，87 例（69 例男性）接受基于电生理图谱的点式 RF 消融治疗（Carto，Biosense Webster，Diamond Bar，CA，美国）。两种技术均在全身麻醉下进行消融。所有患者均在我们中心常规进行 2D 经胸超声心动图检查，在手术前后 24 小时内进行。心包积液在 133 例患者中的 19 例（14.2%）中被检测到。16 例患者表现为轻度积液，1 例为中度积液，2 例为心包填塞。冷冻球囊和 RF 组之间心包积液的发生率无显著差异（11%比 16%）。较长的手术时间、冠状动脉疾病和高血压被认为是 AF 消融过程中发生 PE 的独立预测因素。
CBA 和 RF 消融治疗 AF 后心包积液的发生率相似。心包积液主要为轻度和无症状，具有良性临床结局，无需额外住院天数。
