A comparative study of pericardial effusion and pleural effusion after cryoballoon ablation or radiofrequency catheter ablation of atrial fibrillation

J Cardiovasc Electrophysiol. 2020 May;31(5):1062-1067. doi: 10.1111/jce.14423. Epub 2020 Mar 4.

Abstract

Introduction: The incidence and clinical outcome of pericardial and pleural effusion after cryoballoon ablation (CBA) or radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) have not been fully investigated.

Methods: A total of 60 patients with paroxysmal AF were treated with either CBA (n = 30) or RFCA (n = 30) groups, with assessment of serum troponin I level, left atrial pulmonary vein computed tomography (CT) angiography and echocardiography within 24 hours before ablation, and serum troponin I level at 12 hours, and chest CT and echocardiography within 24 hours postablation. Repeat chest CT was performed 1 month after the index procedure in patients with pericardial or pleural effusion.

Results: With similarly distributed baseline characteristics, the CBA group relative to the RFCA group had postablation: higher serum troponin I level (13.48 vs 1.84 µg/L, P < .001); similarly high pericardial effusion rates on chest CT (80% vs 93.3%, P > .05), with chest CT yielding significantly higher detection rate than echocardiography; similarly high pleural effusion rates on chest CT (73.3% vs 80%, P > .05); and smaller maximum depths on chest CT cross-section of pericardial effusion (5.21 ± 3.37 vs 7.13 ± 2.68 mm, P < .05) and pleural effusion bilaterally (left: 4.16 ± 4.90 vs 6.96 ± 5.42 mm; right: 5.04 ± 4.46 vs 7.55 ± 4.95 mm, both P < .05). The effusions self-resolved within a mean period of 1 month.

Conclusions: Both CBA and RFCA were associated with high rates of pericardial and pleural effusion, with RFCA yielding numerically higher incidence and significantly higher effusion extent, and chest CT significantly higher detection rates than echocardiography.

Keywords: atrial fibrillation; catheter ablation; pericardial effusion; pleural effusion.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Aged
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / epidemiology
  • Atrial Fibrillation / surgery*
  • Biomarkers / blood
  • Catheter Ablation / adverse effects*
  • China / epidemiology
  • Cryosurgery / adverse effects*
  • Echocardiography
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pericardial Effusion / diagnostic imaging
  • Pericardial Effusion / epidemiology*
  • Pleural Effusion / diagnostic imaging
  • Pleural Effusion / epidemiology*
  • Risk Factors
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Troponin I / blood

Substances

  • Biomarkers
  • Troponin I