Table 2.
Incidence of procedure related complications of left vs. right atrial ablations, stratified by centre ablation volume
| Complications, n (%) | Isolated pulmonary vein isolation and/or left atrial ablation |
Isolated right atrial ablation |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Centre ablation volume |
Centre ablation volume |
|||||||||
| ≤25 (n = 33), n (95% CI) (%) | 26–50 (n = 258), n (95% CI) (%) | 51–100 (n = 642), n (95% CI) (%) | 101–300 (n = 5636), n (95% CI) (%) | >300 (n = 10 780), n (95% CI) (%) | ≤25 (n = 261), n (95% CI) (%) | 26–50 (n = 667), n (95% CI) (%) | 51–100 (n = 1158), n (95% CI) (%) | 101–300 (n = 4996), n (95% CI) (%) | >300 (n = 6789), n (95% CI) (%) | |
| In-hospital death* | 0 (0–5) (0) | 0 (0–5) (0) | 0 (0–5) (0) | 8 (3–17) (0.1) | 8 (3–17) (0.1) | 0 (0–5) (0) | n.a. | n.a. | 20 (12–32) (0.4) | 20 (12–32) (0.3) |
| Stroke* | 0 (0–5) (0) | n.a. | n.a. | 29 (19–43) (0.5) | 60 (46–78) (0.6) | n.a. | n.a. | 7 (3–16) (0.6) | 33 (23–47) (0.7) | 26 (17–39) (0.4) |
| Pneumonia* | n.a. | 3 (0–10) (1.2) | 11 (5–21) (1.7) | 62 (47–80) (1.1) | 65 (50–84) (0.6) | 7 (3–15) (2.7) | 10 (5–19) (1.5) | 28 (19–41) (2.4) | 141 (120–165) (2.8) | 96 (78–118) (1.4) |
| Phrenic nerve injury* | 0 (0–5) (0) | 0 (0–5) (0) | n.a. | 9 (4–18) (0.2) | 14 (7–25) (0.1) | 0 (0–5) (0) | 0 (0–5) (0) | n.a. | n.a. | 6 (2–14) (0.1) |
| Cardiac arrest* | 0 (0–5) (0) | n.a. | 3 (0–10) (0.5) | 16 (9–27) (0.3) | 13 (7–23) (0.1) | 0 (0–5) (0) | n.a. | n.a. | 21 (13–33) (0.4) | 25 (16–38) (0.4) |
| AV block III°* | 0 (0–5) (0) | 0 (0–5) (0) | n.a. | 18 (11–30) (0.3) | 31 (21–45) (0.3) | 4 (1–11) (1.5) | 9 (4–18) (1.3) | 13 (7–23) (1.1) | 87 (70–107) (1.7) | 110 (90–133) (1.6) |
| Pericardial effusion | n.a. | 7 (3–15) (2.7) | 18 (11–29) (2.8) | 184 (159–213) (3.3) | 370 (334–410) (3.4) | 5 (1–13) (1.9) | 8 (3–17) (1.2) | 13 (7–23) (1.1) | 101 (83–122) (2.0) | 110 (90–133) (1.6) |
| Pericardial drainage* | 0 (0–5) (0) | n.a. | 6 (1–11) (0.9) | 67 (51–83) (1.2) | 110 (89–131) (1.0) | 0 (0–5) (0) | n.a. | n.a. | 21 (12–30) (0.4) | 24 (14–34) (0.4) |
| Access site complications | 6 (2–12) (18.2) | 21 (13–32) (8.1) | 75 (60–93) (11.7) | 434 (395–476) (7.7) | 762 (710–817) (7.1) | 10 (5–19) (3.8) | 27 (18–40) (4.0) | 46 (34–62) (4.0) | 183 (159–209) (3.7) | 270 (239–304) (4.0) |
| Vascular intervention/surgery* | 0 (0–5) (0) | 5 (1–9) (1.9) | n.a. | 69 (53–85) (1.2) | 53 (39–67) (0.5) | n.a. | n.a. | 8 (2–14) (0.7) | 29 (18–40) (0.6) | 34 (23–45) (0.5) |
| Transfusion* | n.a. | 4 (0–8) (1.6) | 10 (4–16) (1.6) | 127 (105–149) (2.3) | 150 (126–174) (1.4) | n.a. | n.a. | 24 (14–34) (2.1) | 81 (63–99) (1.6) | 104 (84–124) (1.5) |
| Total, overall | 6 (2–12) (18.2) | 31 (20–42) (13.2) | 108 (88–128) (17.4) | 760 (706–814) (14.1) | 1323 (1252–1394) (12.8) | 26 (16–36) (10.0) | 54 (40–68) (8.1) | 107 (87–127) (11.2) | 586 (539–633) (13.2) | 663 (613–713) (10.7) |
| Total, major | 0 (0–5) (0) | 12 (5–19) (5.8) | 30 (19–91) (5.5) | 405 (366–444) (7.8) | 504 (460–548) (5.2) | 11 (4–18) (4.2) | 27 (17–37) (4.0) | 80 (62–98) (8.9) | 433 (392–474) (10.1) | 445 (404–486) (7.5) |
Major complications are marked by an asterisk (*). Complications are presented as incidence (percentage), stratified by centre ablation volume and by any pulmonary vein isolation and/or left atrial ablation or isolated right atrial ablation. Centre ablation volume was categorized by centres performing ≤25, 26–50, 51–100, 101–300, or >300 of the respective procedures.
For Table 2, Group 4 (additional right atrial ablation) is eliminated from the analysis on the left of the table, but the sum (17 349 procedures) is more than the sum of Groups 1–3 (17 111 procedures), as in 238 cases both cryo-energy and RF energy were applied, which are not represented in Table 1.
n.a., not assessed (indicates table cell with too few observations for display due to data protection policies).