Safety of catheter ablation in patients with recently implanted cardiac implantable electronic device: A 5‐year experience

Introduction Catheter ablation (CA) can interfere with cardiac implantable electronic device (CIED) function. The safety of CA in the 1st year after CIED implantation/lead revision is uncertain. Methods This single center, retrospective cohort included patients who underwent CA between 2012 and 2017 and had a CIED implant/lead revision within the preceding year. We assessed the frequency of device/lead malfunctions in this population. Results We identified 1810 CAs in patients between 2012 and 2017, with 170 CAs in 163 patients within a year of a CIED implant/lead revision. Mean age 68 ± 12 years (68% men). Time between the CIED procedure and CA was 158 ± 99 days. The CA procedures included AF ablation ( n = 57, 34%), AV node ablation ( n = 40, 24%), SVT ablation ( n = 37, 22%), and PVC/VT ablations ( n = 36, 21%). The cumulative frequency of lead dislodgement, significant CIED dysfunction, and/or CIED‐related infection following CA was ( n = 1/170, 0.6%). There was a single atrial lead dislodgement (0.6%). There were no instances of power‐on‐reset or CIED‐related infection. Following CA, there was no significant difference in RA or RV lead sensing ( p = 0.52 and 0.84 respectively) or thresholds ( p = 0.94 and 0.17 respectively). The RA impedance slightly decreased post‐CA from 474 ± 80 Ohms to 460 ± 73 Ohms ( p = 0.002), as did the RV impedance (from 515 ± 111 Ohms to 497 ± 98 Ohms, p < 0.0001). Conclusions CA can be performed within 1 year following CIED implantation/lead revision with a low risk of CIED/lead malfunction or lead dislodgement. The ideal time to perform CA after a CIED remains uncertain.