From the Guidelines
Cardiac ablation procedures can cause several side effects, with a risk of serious complications ranging from 0.8% to 6% depending on the type of ablation and patient comorbidities. The most common side effects include bruising, soreness, or bleeding at the catheter insertion site, typically in the groin area, as well as chest discomfort, palpitations, or mild chest pain for a few days following the procedure 1. Fatigue is also common and may last for several weeks. More serious but less common side effects include:
- Blood vessel damage
- Heart perforation causing bleeding around the heart (cardiac tamponade)
- Stroke or TIA from blood clots
- Heart attack
- Damage to the heart's electrical system requiring a pacemaker
- Narrowing of pulmonary veins
- Damage to nearby structures like the esophagus or phrenic nerve Infection at the insertion site or within the bloodstream occurs rarely. According to a 2017 study, the risk of major adverse postprocedural events varies by ablation type, with rates of 0.8% for SVT, 3.4% for idiopathic VT, 6% for VT ablation in the setting of structural heart disease, and 5.2% for AF 1. Patients should contact their doctor immediately if they experience severe chest pain, shortness of breath, significant bleeding, or signs of infection after the procedure. It is essential to note that the risk of serious complications is generally low, and most patients recover fully without long-term issues, with the benefits of catheter ablation, including improved quality of life, often outweighing the risks 1.
From the Research
Side Effects of Cardiac Ablations
- Cardiac ablations can result in various complications, including volume overload, phrenic nerve injury, and other events 2
- The incidence of complications can vary depending on the type of ablation procedure used, with radiofrequency ablation (RFA) associated with more total complications compared to cryoballoon ablation (CBA) 2
- Cryoablation has been shown to have a lower risk of complications, such as threshold rise, compared to RFA in certain contexts, but this may not always be the case 3
- The risk of complications can also depend on the specific technique and technology used, such as the distance from the ablation site to the His lead in AVN ablation 3
Comparison of Ablation Techniques
- Cryoballoon ablation and radiofrequency ablation have been compared in several studies, with cryoballoon ablation often showing shorter procedure times and lower re-ablation rates 2, 4
- However, the choice of ablation technique may depend on various factors, including the type of arrhythmia being treated and the individual patient's characteristics 5, 6
- The use of intracardiac echocardiography and image integration can help guide the ablation procedure and reduce the risk of complications 6
Specific Complications
- Phrenic nerve injury is a potential complication of cryoballoon ablation, occurring in approximately 0.9% of cases 2
- Volume overload is a complication that can occur with radiofrequency ablation, and is more common with this technique compared to cryoballoon ablation 2
- Other complications, such as cardiac tamponade and stroke, can also occur with cardiac ablation procedures, although the risk is generally low 5