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Cardiac Catheter Ablation

Indications
1. Atrial flutter
  1. High efficacy and low complication rate
2. Atrial Fibrillation and very symptomatic (esp. in young patients)
  1. Low efficacy and high complication rate
Efficacy
1. Atrial flutter
  1. Longterm efficacy: 95%
2. Atrial Fibrillation
  1. Recurrence rate despite ablation: 10-44%
Complications
1. Atrial flutter
  1. Ablation is at isthmus and is a low risk procedure
2. Atrial Fibrillation
  1. Ablation site is high risk due to proximity of major structures
  2. Complications (as high as 6% complication rate)
    1. Pulmonary vein stenosis
    2. Cerebrovascular Accident
    3. Cardiac perforation
    4. Atrial-esophageal fistula (rare)
Protocol: Refractory and symptomatic Atrial Fibrillation despite maximal therapy
1. AV Node Ablation with Pacemaker placement
  1. Last resort method that is rarely indicated
  2. Ozcan (2001) N Engl J Med 344:1043

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This page was written by Scott Moses, MD. This page was last revised on 12/6/2007 11:44:12 AM. This page was last published on 5/16/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.