Arrhythmias & electrophysiology
Iatrogenic aortic dissection during catheter ablation for ventricular arrhythmia
Authors' 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.
Study context
- Population
- Patients who sustained iatrogenic aortic dissection (AD) during retrograde aortic ventricular arrhythmia (VA) ablation at 6 centers between January 1, 2011, and September 30, 2023patients who underwent ablation procedures during the study period, iatrogenic AD in 18
- Participants
- 5,925 patients
- Comparison
- Type A AD vs type B AD
- Type A ADn = 8
- Type B ADn = 10
- Outcome
- Incidence of iatrogenic AD during the procedure
Methodological details6 centers, prospectively identified
- 6 centers
- Prospectively identified
Main finding
As reported in the abstract
Iatrogenic AD
18
0.3%
Further findings
| Outcome | Type A AD | Type B AD |
|---|---|---|
| Management | ||
| Surgical repair (antegrade dissection), of the type A AD patients | 3 (37.5%) | — not stated in the abstract |
| Successfully managed conservatively (retrograde dissection), of the type A AD patients | 2 (25%) | — not stated in the abstract |
| Endovascular intervention, of the type B AD patients | — not stated in the abstract | 3 (30%) |
| Managed medically, of the type B AD patients | — not stated in the abstract | 7 (70%) |
— not stated in the abstract
Patient characteristics
- Mean age
- 65.4 ± 5.3 years
- Female
- 5 patients (27.8%)
Catheter resistance
- Considerable catheter resistance was reported in all cases
Presenting symptoms
- Sudden-onset severe chest pain
- n = 13 [72.2%]
- Back pain
- n = 9 [50%]
- Abdominal pain
- n = 3 [16.7%]
- Syncope
- n = 3 [16.7%]
Death
- Died; all had type A AD and died of severe hemodynamic compromise
- 3 patients (16.7%)
Aorta-related complications among the 15 survivors · mean follow-up of 72.7 ± 46.8 months
- None of the 15 survivors had aorta-related complications
Original publication
Iatrogenic aortic dissection during catheter ablation for ventricular arrhythmia. Heart Rhythm. Published 4 March 2025. doi:10.
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