Atrial fibrillation (AF) ablation has made huge progress with respect to innovation,
efficacy, and safety, however, complications are still present. Recent studies examined
various predictors of complications. However, limited data exist regarding the role
of a repeat procedure. Our aim was the prospective evaluation of the incidence and
predictors of complications related to AF ablation procedures in consecutive patients,
including repeat procedures.All ablation procedures for AF between January 2013 and
December 2015 were analysed in our electrophysiology laboratory. During the study
period 1243 procedures were analysed [394 female, median age 62 (55-69)]. Overall
complication rate was 6.84%, major complication rate was 2.82%. Major complications
were the following: 18 pericardial tamponades; 5 pseudoaneurysms; 1 arteriovenous
fistula; 6 thromboembolic cerebrovascular events; 3 pulmonary vein stenosis; and 2
atrioventricular blocks. No atrio-oesophageal fistula or procedure related death occurred.
Univariate analysis for overall complications showed that age ≥ 65 years (P = 0.0231),
female gender (P = 0.0438), hypertension (P = 0.0488), CHA2DS2-VASc score ≥ 2 (P =
0.0156), and previous AF ablation procedure (P < 0.0001) is associated with higher
risk for adverse events. Multivariate analysis showed that the only independent predictor
of overall complications was previous AF ablation procedure (P < 0.0001). Similarly,
the only predictor of major complications was previous AF ablation procedure (P <
0.0001).Incidence of complications associated with AF ablation in our high volume
electrophysiology laboratory is similar to other cohorts. The only independent predictor
of complications was previous AF ablation procedure in our series.
