Europace Advance Access originally published online on December 24, 2008
Europace 2009 11(2):155-157; doi:10.1093/europace/eun360
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Ablation for Atrial Fibrillation
Routine echocardiography after radiofrequency ablation: to flog a dead horse?
*Department of Cardiology, University Hospital, Petersgraben 4, 4031 Basel, Switzerland
Aims: Radiofrequency ablation (RFA) is frequently used to treat sustained arrhythmias. One major complication is pericardial effusion–tamponade. Therefore, many centres perform echocardiography after interventions, but data on necessity of such routine procedures are scarce.
Methods and results: We included 510 patients with RFA and compared echocardiographic results acquired before and <24 h after intervention. We defined pericardial effusion as ‘small’, if <10 mm in diastole, ‘moderate’ if >10 mm, ‘large’ if >20 mm, or tamponade (>20 mm with haemodynamic compromise). Age was 55 ± 16 years, 40% were females. Thirty-five percentage underwent RFA for atrioventricular nodal re-entrant tachycardia (AVNRT), 28% for atrial flutter, 15% for atrial fibrillation (AF), 12% for Wolff-Parkinson-White (WPW) syndrome, and 10% for different other arrhythmias. In 16 patients (3.2%), small asymptomatic effusions were detected. The only moderate effusion was suspected due to procedure circumstances. Radiofrequency ablation for AF had a higher incidence compared to AVNRT and flutter (P = 0.001 and <0.0001, respectively) or to WPW syndrome (P = 0.06).
Conclusion: Numbers of significant pericardial effusion as detected by routine echocardiography were low (3.6%) and clinically relevant effusions absent. We thus recommend performing echocardiography after RFA only, if effusion is suspected clinically or if RFA was performed for AF, due to the high incidence of effusions with this type of ablation.
Key Words: Echocardiography, Radiofrequency ablation, Supraventricular tachycardia, Pericardial effusion
* Corresponding author. Tel: +41 61 328 62 22, Fax: +41 61 265 45 98, Email: bschaer{at}uhbs.ch
Part of the data has been presented at the Congress of the European Society of Cardiology in Vienna on the 2nd of September 2007.
The first two authors contributed equally to the study.
Manuscript submitted 3 October 2008. Accepted after revision 27 November 2008.
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