Iatrogenic aortic dissection during catheter ablation for ventricular arrhythmia.

IF 5.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart rhythm Pub Date : 2025-03-04 DOI:10.1016/j.hrthm.2025.02.046

Ke Chen, Weili Ge, Yiwei Lai, Deyong Long, Caihua Sang, Ronghui Yu, Ribo Tang, Songnan Li, Chenxi Jiang, Xianqing Wang, Weifeng Song, Erpeng Liang, Xiaobiao Zang, Jifang Ma, Jungang Nie, Liguo Jian, Shuiyin Ding, Chuanyu Gao, Rong Bai, Jianzeng Dong, Changsheng Ma

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引用次数: 0

Abstract

Background: Attempted catheter manipulation through the retrograde aortic approach carries a risk of aortic dissection (AD) during catheter ablation.

Objective: This study aimed to determine the incidence, management, and outcomes of iatrogenic AD associated with ablation of ventricular arrhythmia (VA).

Methods: All patients who sustained iatrogenic AD during retrograde aortic VA ablation at 6 centers between January 1, 2011, and September 30, 2023, were prospectively identified.

Results: Of 5925 patients who underwent ablation procedures during the study period, iatrogenic AD developed in 18 (0.3%; 8 type A AD, 10 type B AD) during the procedure. The mean age was 65.4 ± 5.3 years, and 5 patients (27.8%) were female. Considerable catheter resistance was reported in all cases. Presenting symptoms included sudden-onset severe chest pain (n = 13 [72.2%]), back pain (n = 9 [50%]), abdominal pain (n = 3 [16.7%]), and syncope (n = 3 [16.7%]). Of the type A AD patients, 3 (37.5%) with antegrade dissection underwent surgical repair, and 2 (25%) with retrograde dissection were successfully managed conservatively. Three (30%) of the type B AD patients underwent endovascular intervention and 7 (70%) were managed medically. Three patients (16.7%) died; all had type A AD and died of severe hemodynamic compromise. None of the 15 survivors had aorta-related complications during a mean follow-up of 72.7 ± 46.8 months.

Conclusion: Iatrogenic AD is a rare but potentially lethal complication of retrograde aortic VA ablation. Comprehensive measures should be taken to reduce the risk of iatrogenic AD.

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来源期刊

Heart rhythm 医学-心血管系统

CiteScore

10.50

自引率

5.50%

发文量

1465

审稿时长

24 days

期刊介绍： HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability. HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community. The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.