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      Intra-atrial endothelial lesion resulting from transseptal puncture for catheter ablation of atrial fibrillation

      case-report

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          Abstract

          Thromboembolic events are known complications of left atrial ablation therapy. We describe a complication which may also lead to systemic thromboembolism that has not been reported so far: the formation of a moving structure attached to the fossa ovalis after an attempted transseptal puncture in a 66-year old patient with symptomatic paroxysmal atrial fibrillation.

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          Most cited references3

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          Worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation.

          The purpose of this study was to conduct a worldwide survey investigating the methods, efficacy, and safety of catheter ablation (CA) of atrial fibrillation (AF). A detailed questionnaire was sent to 777 centers worldwide. Data relevant to the study purpose were collected from 181 centers, of which 100 had ongoing programs on CA of AF between 1995 and 2002. The number of patients undergoing this procedure increased from 18 in 1995 to 5050 in 2002. The median number of procedures per center was 37.5 (range, 1 to 600). Paroxysmal AF, persistent AF, and permanent AF were the indicated arrhythmias in 100.0%, 53.0%, and 20.0% of responding centers, respectively. The most commonly used techniques were right atrial compartmentalization between 1995 and 1997, ablation of the triggering focus in 1998 and 1999, and electrical disconnection of multiple pulmonary veins between 2000 and 2002. Of 8745 patients completing the CA protocol in 90 centers, of whom 2389 (27.3%) required >1 procedure, 4550 (52.0%; range among centers, 14.5% to 76.5%) became asymptomatic without drugs and another 2094 (23.9%; range among centers, 8.8% to 50.3%) became asymptomatic in the presence of formerly ineffective antiarrhythmic drugs over an 11.6+/-7.7-month follow-up period. At least 1 major complication was reported in 524 patients (6.0%). The findings of this survey provide a picture of the variable and evolving methods, efficacy, and safety of CA for AF as practiced in a large number of centers worldwide and may serve as a guide to clinicians considering therapeutic options in patients suffering from this arrhythmia.
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            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.

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              Four types of complications in paroxysmal atrial fibrillation ablation.

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                Author and article information

                Journal
                Heart Int
                HI
                HI
                Heart International
                PAGEPress Publications (Pavia, Italy )
                1826-1868
                2036-2579
                05 June 2012
                05 June 2012
                : 7
                : 2
                : e8
                Affiliations
                Otto-von-Guericke University, University Hospital Magdeburg, Division of Cardiology, Section of Electrophysiology, Magdeburg, Germany
                Author notes
                Correspondence: Samir M. Said, Otto-von-Guericke University, University Hospital, Division of Cardiology, Section of Electro-physiology, Leipziger Str. 44, 39120 Magdeburg, Germany. Tel. +49.391.67.15206 - Fax: +49.391.67.15211. E-mail: samir.said@ 123456med.ovgu.de
                Article
                hi.2012.e8
                10.4081/hi.2012.e8
                3504307
                23185682
                f6151ce5-a610-45c4-91c5-abea320d3eb3
                ©Copyright C. Genz et al., 2012

                This work is licensed under a Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0).

                Licensee PAGEPress, Italy

                History
                : 13 November 2011
                : 29 February 2012
                : 09 March 2012
                Categories
                Case Report

                Cardiovascular Medicine
                atrial fibrillation,complications.,cardiology
                Cardiovascular Medicine
                atrial fibrillation, complications., cardiology

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