Management of Tamponade Complicating Catheter Ablation for Atrial Fibrillation: Early Removal of Pericardial Drains Is Safe and Effective and Reduces Analgesic Requirements and Hospital Stay Compared to Conventional Delayed Removal

JACC. Clinical Electrophysiology
Michala E F PedersenYaver Bashir

Abstract

This study reports on the safety of early removal of pericardial drains after cardiac tamponade complicating atrial fibrillation catheter ablation (AFCA) procedures, the need for repeat pericardiocentesis, major adverse outcomes, as well as length of stay, and the need for opiate analgesia. Tamponade from AFCA is traditionally managed by pericardiocentesis with delayed removal of the drain (typically 12 to 24 h later) in case of re-bleeding. A drain in situ often causes severe pain but ongoing blood loss is rare. Our institution adopted the practice of early removal of drains before leaving the laboratory if bleeding has stopped. The authors performed a retrospective descriptive analysis of 43 cases of tamponade complicating AFCA from 2006 to 2015, comparing patients in whom the drain was removed early (group early removal [ER]; n = 25) versus traditional delayed removal (group delayed removal [DR]; n = 18). The groups were similar with respect to clinical/demographic characteristics, proportions of first-time versus re-do and pulmonary vein isolation versus pulmonary vein isolation + additional ablation. There were no deaths. No ER patients required drain re-insertion before discharge. The length of stay was shorter in the ER ...Continue Reading

References

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Citations

Jan 25, 2020·Journal of Cardiovascular Electrophysiology·Kavisha Patel, Luigi Di Biase
Apr 17, 2020·Journal of Cardiovascular Electrophysiology·Qianqian Zhao, Nian Liu

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