Arrhythmias & electrophysiology
Stroke and Bleeding Risks of Endocardial Ablation for Ventricular Arrhythmias
Authors' conclusion
Stroke is a rare complication of radiofrequency catheter ablation for ventricular arrhythmia using ASA 325 mg/d as a minimal postprocedure regimen with more potent regimens for selected patients.
Study context
- Population
- Patients undergoing endocardial radiofrequency catheter ablation for ventricular arrhythmias (median age 64 years, 70.3% men, 71.6% with cardiomyopathy)
- Participants
- 616 patients663 procedures
- Outcome
- Embolic and bleeding complications in relation to pre- and post-periprocedure antithrombotic regimens
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
- Stroke
- 2 (0.3%; 95% CI: 0.0%-0.8%)
- TIA
- 1 (0.15%)
- PE
- 2 (0.3%)
- Bleeding complications
- 39 (5.9%)
- Pericardial effusions
- 11 (1.7%)
- Vascular access bleeding
- 28 (4.2%)
Observational data: associations, not effects.
Further findings
Predictors of bleeding complications (preprocedure antithrombotics)
- Non-ASA antiplatelet use, OR
- 2.846; P = 0.011
- DOAC use, OR
- 2.585; P = 0.032
Antithrombotic regimens
- Preprocedure antithrombotic agents
- 464 (70.0%)
- Preprocedure aspirin alone (ASA) alone
- 220 (33.2%)
- Preprocedure warfarin or DOAC
- 163 (24.6%)
- Postablation ASA 325 mg/d
- 49.8%
- Postablation DOAC or warfarin
- 30.3%
- New DOAC or warfarin initiated
- 6.6%
- Same preprocedure regimen continued
- 39.7%
Original publication
Stroke and Bleeding Risks of Endocardial Ablation for Ventricular Arrhythmias. JACC Clin Electrophysiol. Published 6 December 2023. doi:10.
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