Complications of catheter ablation of tachyarrhythmias: Occurrence, protection, prevention

Complications occurring in a series of 25 patients undergoing ablation attempts directed at the AV junction, WPW and ventricular tachycardia were analyzed. Perforation with tamponade was the most serious complication; the presence of a surgeon during the ablation attempt proved life-saving and changes in catheter type, position and delivered energies have been recommended to reduce the incidence of this complication. The catheters must be chosen carefully to avoid lead disintegration during ablation. Pericarditis occurs in about 10% of patients but requires only symptomatic therapy. Fluid balance requires attention, especially during lengthy procedures. Hemodynamic monitoring is essential. Following ablation procedures, evolutionary changes may require several weeks to months for full development so that long-term effects cannot always be predicted during the initial hospitalization. Pacemaker implantation is mandatory following attempted ablation of the AV junction.