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  • Title: Acute pericardial effusion following atrial fibrillation ablation: characteristics and relationship with arrhythmia recurrences.
    Author: Lellouche N, Sebag FA, Elbaz N, Hassine M, Chaachoui N, Teiger E, Dubois-Randé JL, Lim P.
    Journal: Arch Cardiovasc Dis; 2011 Aug; 104(8-9):450-7. PubMed ID: 21944147.
    Abstract:
    BACKGROUND: Pericardial effusion (PE) can occur during or after atrial fibrillation (AF) ablation, and may induce atrial arrhythmia. AIM: To characterize the impact of PE on arrhythmia recurrences following AF ablation. METHODS: Patients referred for a first radiofrequency AF ablation were studied prospectively. Transthoracic echocardiography was performed before and 24h after the procedure. If PE was present, transthoracic echocardiography was repeated at 1 month to evaluate PE evolution. Early arrhythmia recurrences (EARs) were defined as any arrhythmia documented within 1 month of the procedure. RESULTS: PE was diagnosed in 18/81 patients (22%); and was present in significantly more patients with persistent versus paroxysmal AF (14/40 [35%] vs 4/41 [10%]; P=0.008). PEs were mild (mean 6 ± 3mm), mainly asymptomatic (89%), and none required pericardiocentesis. Early and late arrhythmia recurrences were present in 25/81 (31%) and 29/81 (36%), respectively. The incidence of PE was significantly higher among patients with EARs versus those without (12/25 [48%] vs 6/56 [11%]; P=0.0004). By multivariable analysis, PE and duration in AF were the two independent predictors of EARs. PE incidence was similar in patients with and without late arrhythmia recurrences. At 1 month, no patients had PE on transthoracic echocardiography. CONCLUSION: PE following radiofrequency AF ablation is frequent, particularly following persistent AF ablation. This effusion is generally mild, mainly asymptomatic, and independently associated with EARs.
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