Pulmonary Vein Isolation

From Ask Dr Wiki

Contents 1 Preprocedure Protocol 2 Procedural Protocol 3 Complications 3.1 Access 3.2 Transeptal 3.3 Esophageal Temperature Probe Related 3.4 Ablation 3.5 Lasso Catheter Related 3.6 Post Ablation 4 Post Procedure Follow Up

Preprocedure Protocol

1. Discontinue all Antiarrhythmics for 5 1/2 lives and Amiodarone for one month.
2. Check INR every week for 4 weeks.
3. Perform TEE the day prior or the day of the PVI.
4. Perform a CT scan preprocedure

Procedural Protocol

1. Equipment List
2. Sedation Protocol
3. Heparin Protocol
4. Ablation Protocol
5. Pruka Setup

Complications

Access

1. Femoral Pseudoaneurysm
2. AV Fistula
3. Retroperitoneal Hemorrhage
4. Hemothorax

Transeptal

1. Air Embolism
2. Aortic Puncture or Dissection

Esophageal Temperature Probe Related

1. Esophageal tear

Ablation

1. Sinus Node Injury
2. Phrenic Nerve Paralysis
3. Recurrent Laryngeal Nerve Paralysis
4. AV Block
5. Coronary Artery Occlusion
6. Congestive Heart Failure with irrigated tip catheter
7. CVA
8. Atrial Esophageal Fistula
9. Atrial Bronchial Fistula
10. Pulmonary Vein Stenosis
11. Cardiac Tamponade
12. Intracardiac Hematoma
13. Gastroparesis

Lasso Catheter Related

1. Mitral Valve Entrapment

Post Ablation

1. Post ablation Hypotension
2. Left Atrial Flutter
3. Sepsis

Post Procedure Follow Up

1. Holter transmission three times a week or with symptoms
2. Anti-arrhythmic for 8 weeks
3. CT scan at 12 weeks