Key result
Direct autotransfusion shows no difference in periprocedural death vs standard care during AF ablation tamponade.
Why the study?
Data regarding the safety and feasibility of direct autotransfusion for acute pericardial tamponade during catheter ablation for atrial fibrillation are rare and limited.
Observational (n=73)
No
Absolute Event Rate: 0% vs 3.7%
p-value: p=0.370
May support autotransfusion for ablation-related tamponade; hypothesis-generating and requires randomized confirmation before practice change.
Background: Acute pericardial tamponade (APT) is one of the most serious complications of catheter ablation for atrial fibrillation (AF-CA). Direct autotransfusion (DAT) is a method of reinjecting pericardial blood directly into patients through vein access without a cell-salvage system. Data regarding DAT for APT are rare and provide limited information. Our present study aims to further investigate the safety and feasibility of DAT in the management of APT during the AF-CA procedure. Methods and results: We retrospectively reviewed 73 cases of APT in the perioperative period of AF-CA from January 2014 to October 2021 at our institution, among whom 46 were treated with DAT. All included patients successfully received emergency pericardiocentesis through subxiphoid access guided by X-ray. Larger volumes of aspirated pericardial blood (658.4 ± 545.2 vs. 521.2 ± 464.9 ml), higher rates of bridging anticoagulation (67.4 vs. 37.0%), and surgical repair (6 vs. 0) were observed in patients with DAT than without. Moreover, patients with DAT were less likely to complete AF-CA procedures (32/46 vs. 25/27) and had a lower incidence of APT first presented in the ward (delayed presentation) (8/46 vs. 9/27). There was no difference in major adverse events (death/disseminated intravascular coagulation/multiple organ dysfunction syndrome and clinical thrombosis) (0/0/1/0 vs. 1/0/0/0), other potential DAT-related complications (fever/infection and deep venous thrombosis) (8/5/2 vs. 5/3/1), and length of hospital stay (11.4 ± 11.6 vs. 8.3 ± 4.7 d) between two groups. Conclusion: DAT could be a feasible and safe method to deal with APT during AF-CA procedure.
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Liu et al. (2022) conducted an observational in Acute pericardial tamponade during catheter ablation for atrial fibrillation (n=73). Direct autotransfusion vs. No direct autotransfusion was evaluated on Periprocedural death (p=0.370). Direct autotransfusion for acute pericardial tamponade during atrial fibrillation ablation was feasible and safe, with no significant difference in periprocedural death (0% vs 3.7%) or other major adverse events compared to standard management.
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