Feasibility of Performing Radiofrequency Catheter Ablation and Endomyocardial Biopsy in the Same Setting

J. William Schleifer, Kevin K. Manocha, Samuel J Asirvatham, Peter Noseworthy, Rajiv Gulati, Paul Andrew Friedman, Malini Madhavan, Thomas M. Munger, Leslie T Jr. Cooper, Guy S. Reeder, David Holmes, Suraj Kapa

Research output: Contribution to journalArticle

Abstract

In patients with unexplained cardiomyopathy, electroanatomical mapping can identify abnormal tissue to target during electrophysiology-guided endomyocardial biopsy (EP-guided EMB). The objective of this study is to determine whether catheter ablation performed in the same setting as EP-guided EMB increases procedural risk. Sixty-seven patients (mean age 54.4 ± 13.8, 57% male) undergoing EP-guided EMB were included. Radiofrequency catheter ablation was performed in 17 patients (25%) for ventricular arrhythmias and in 2 (3%) for typical atrial flutter. Femoral arterial access was obtained in 90% ablation patients and 40% biopsy-only patients; vascular access complications were more common in the ablation group than in the EMB-only group (p = 0.02). There were no significant differences in rate of tricuspid regurgitation, thromboembolism, or pericardial effusion, whether procedural anticoagulation was used. In conclusion, catheter ablation and procedural anticoagulation can be combined with EP-guided EMB with an increased risk of vascular access complications, but no significant increase in intracardiac complications.

Original languageEnglish (US)
JournalAmerican Journal of Cardiology
DOIs
StateAccepted/In press - Jan 1 2018

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Catheter Ablation
Electrophysiology
Biopsy
Blood Vessels
Tricuspid Valve Insufficiency
Atrial Flutter
Pericardial Effusion
Thromboembolism
Thigh
Cardiomyopathies
Cardiac Arrhythmias

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{fc88d496ad634a2c823ecb1115925e29,
title = "Feasibility of Performing Radiofrequency Catheter Ablation and Endomyocardial Biopsy in the Same Setting",
abstract = "In patients with unexplained cardiomyopathy, electroanatomical mapping can identify abnormal tissue to target during electrophysiology-guided endomyocardial biopsy (EP-guided EMB). The objective of this study is to determine whether catheter ablation performed in the same setting as EP-guided EMB increases procedural risk. Sixty-seven patients (mean age 54.4 ± 13.8, 57{\%} male) undergoing EP-guided EMB were included. Radiofrequency catheter ablation was performed in 17 patients (25{\%}) for ventricular arrhythmias and in 2 (3{\%}) for typical atrial flutter. Femoral arterial access was obtained in 90{\%} ablation patients and 40{\%} biopsy-only patients; vascular access complications were more common in the ablation group than in the EMB-only group (p = 0.02). There were no significant differences in rate of tricuspid regurgitation, thromboembolism, or pericardial effusion, whether procedural anticoagulation was used. In conclusion, catheter ablation and procedural anticoagulation can be combined with EP-guided EMB with an increased risk of vascular access complications, but no significant increase in intracardiac complications.",
author = "Schleifer, {J. William} and Manocha, {Kevin K.} and Asirvatham, {Samuel J} and Peter Noseworthy and Rajiv Gulati and Friedman, {Paul Andrew} and Malini Madhavan and Munger, {Thomas M.} and Cooper, {Leslie T Jr.} and Reeder, {Guy S.} and David Holmes and Suraj Kapa",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.amjcard.2018.02.020",
language = "English (US)",
journal = "American Journal of Cardiology",
issn = "0002-9149",
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TY - JOUR

T1 - Feasibility of Performing Radiofrequency Catheter Ablation and Endomyocardial Biopsy in the Same Setting

AU - Schleifer, J. William

AU - Manocha, Kevin K.

AU - Asirvatham, Samuel J

AU - Noseworthy, Peter

AU - Gulati, Rajiv

AU - Friedman, Paul Andrew

AU - Madhavan, Malini

AU - Munger, Thomas M.

AU - Cooper, Leslie T Jr.

AU - Reeder, Guy S.

AU - Holmes, David

AU - Kapa, Suraj

PY - 2018/1/1

Y1 - 2018/1/1

N2 - In patients with unexplained cardiomyopathy, electroanatomical mapping can identify abnormal tissue to target during electrophysiology-guided endomyocardial biopsy (EP-guided EMB). The objective of this study is to determine whether catheter ablation performed in the same setting as EP-guided EMB increases procedural risk. Sixty-seven patients (mean age 54.4 ± 13.8, 57% male) undergoing EP-guided EMB were included. Radiofrequency catheter ablation was performed in 17 patients (25%) for ventricular arrhythmias and in 2 (3%) for typical atrial flutter. Femoral arterial access was obtained in 90% ablation patients and 40% biopsy-only patients; vascular access complications were more common in the ablation group than in the EMB-only group (p = 0.02). There were no significant differences in rate of tricuspid regurgitation, thromboembolism, or pericardial effusion, whether procedural anticoagulation was used. In conclusion, catheter ablation and procedural anticoagulation can be combined with EP-guided EMB with an increased risk of vascular access complications, but no significant increase in intracardiac complications.

AB - In patients with unexplained cardiomyopathy, electroanatomical mapping can identify abnormal tissue to target during electrophysiology-guided endomyocardial biopsy (EP-guided EMB). The objective of this study is to determine whether catheter ablation performed in the same setting as EP-guided EMB increases procedural risk. Sixty-seven patients (mean age 54.4 ± 13.8, 57% male) undergoing EP-guided EMB were included. Radiofrequency catheter ablation was performed in 17 patients (25%) for ventricular arrhythmias and in 2 (3%) for typical atrial flutter. Femoral arterial access was obtained in 90% ablation patients and 40% biopsy-only patients; vascular access complications were more common in the ablation group than in the EMB-only group (p = 0.02). There were no significant differences in rate of tricuspid regurgitation, thromboembolism, or pericardial effusion, whether procedural anticoagulation was used. In conclusion, catheter ablation and procedural anticoagulation can be combined with EP-guided EMB with an increased risk of vascular access complications, but no significant increase in intracardiac complications.

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