Table 2.
Classification of cardiac tamponade | Cause of tamponade | Supporting evidence | Incidence (n = 51) |
---|---|---|---|
TSP‐related (n = 35) | |||
Type A | Tamponade diagnosed following an attempted TSP with the needle or guidewire; no sheaths passed beyond the interatrial septum | Repeated or challenging attempts at TSP; abnormal pressure trace obtained from TSP needle (e.g. suggestive of aortic or pericardial puncture) | 10 (19.6%) |
Type B | Tamponade diagnosed following passage of the sheath(s) beyond the interatrial septum; no ablation performed | Repeated or challenging attempts at TSP; difficult manipulation of the sheaths or mapping catheter; sheath or mapping catheter seen to pass outside the cardiac silhouette immediately following TSP; abnormal pressure trace obtained from sheath | 19 (37.3%) |
Type C | Tamponade diagnosed immediately following withdrawal of sheaths on conclusion of the procedure | Repeated or challenging attempts at TSP; haemodynamically stable on conclusion of ablation treatment, however sudden haemodynamic deterioration documented following sheath withdrawal | 6 (11.8%) |
Non‐TSP related (n = 16) | |||
Type D | Tamponade diagnosed during ablation treatment or during manipulation of the ablation catheter | High force noted on ablation catheter; clear temporal association between the onset of ablation treatment and haemodynamic deterioration; haemodynamic deterioration whilst ablation catheter within the left atrium; visualization of ablation catheter outside of the cardiac silhouette or left atrial geometry during treatment phase | 13 (25.5%) |
Type E | Tamponade diagnosed during ablation in association with a steam pop | Impedance spike noted during ablation; audible ‘pop’ noted by operator | 2 (3.9%) |
Type F | Tamponade diagnosed during recovery from procedure | Haemodynamically stable following withdrawal of sheaths, but subsequent subacute deterioration documented during recovery | 1 (1.9%) |
Abbreviation: TSP, transseptal puncture.