View source for Cardiac ablation complications

==Background==
*Procedure to address complicated [[arrhythmia]]s (e.g. [[SVT]], [[afib]]/[[atrial flutter|flutter]], [[WPW]]), typically after failing medical management
*Multiple catheters passed through vein/artery into heart, including mapping catheter and ablation catheter, the latter of which heats tissue (often near pulmonary veins) with the abnormal pathway, which is scarred to prevent transmission of abnormal signals. 
*Complications include:
**[[Atrio-esophageal fistula]]: rare but deadly
**Delayed [[cardiac tamponade]]
**[[Stroke]]
**Atypical [[migraine]]
*Overall rate of major complications ~4% <ref> Bertaglia E, Stabile G, Pappone A, Themistoclakis S, Tondo C, De Sanctis V, Soldati E, Tritto M, Solimene F, Grimaldi M, Zoppo F, Pandozi C, Augello G, Calò L, Pappone C. Updated national multicenter registry on procedural safety of catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2013 Oct;24(10):1069-74. doi: 10.1111/jce.12194. Epub 2013 Jun 25. PMID: 23799876.</ref>

==Clinical Features==


==Differential Diagnosis==


==Evaluation==
===Workup===

===Diagnosis===

==Management==
*Therapy based on respective complication
*In general, targeted toward reducing recurrence of [[atrial fibrillation]]
**Management of OSA<ref>Fein AS, Shvilkin A, Shah D, Haffajee CI, Das S, Kumar K, Kramer DB, Zimetbaum PJ, Buxton AE, Josephson ME, Anter E. Treatment of obstructive sleep apnea reduces the risk of atrial fibrillation recurrence after catheter ablation. J Am Coll Cardiol. 2013 Jul 23;62(4):300-5. doi: 10.1016/j.jacc.2013.03.052. Epub 2013 Apr 23. PMID: 23623910.</ref>
**Insufficient evidence for use of steroids, colchicine

==Disposition==
*Strict follow-up with cardiology<ref>European Heart Rhythm Association (EHRA); European Cardiac Arrhythmia Scoiety (ECAS); American College of Cardiology (ACC); American Heart Association (AHA); Society of Thoracic Surgeons (STS), Calkins H, Brugada J, Packer DL, Cappato R, Chen SA, Crijns HJ, Damiano RJ Jr, Davies DW, Haines DE, Haissaguerre M, Iesaka Y, Jackman W, Jais P, Kottkamp H, Kuck KH, Lindsay BD, Marchlinski FE, McCarthy PM, Mont JL, Morady F, Nademanee K, Natale A, Pappone C, Prystowsky E, Raviele A, Ruskin JN, Shemin RJ. HRS/EHRA/ECAS expert Consensus Statement on catheter and surgical ablation of atrial fibrillation: recommendations for personnel, policy, procedures and follow-up. A report of the Heart Rhythm Society (HRS) Task Force on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. 2007 Jun;4(6):816-61. doi: 10.1016/j.hrthm.2007.04.005. Epub 2007 Apr 30. Erratum in: Heart Rhythm. 2009 Jan;6(1):148. PMID: 17556213.</ref>
**First visit at a minimum 3 months, then every 6 months for at least 2 years
**ECGs at all visits

== External Links ==
*[http://www.emdocs.net/complications-of-cardiac-ablation-ed-presentations-evaluation-and-management/ Complications of cardiac ablation: ED presentations, evaluation, and management from emDocs ]

==See Also==
*[[Post-surgical complications]]

==References==
<references/>

[[Category:Surgery]]