TY - JOUR
T1 - Acute Hemoptysis Following Cryoballoon Pulmonary Vein Isolation: A Multicenter Study
AU - Vogler, Julia
AU - Fink, Thomas
AU - Sohns, Christian
AU - Sommer, Philipp
AU - Pott, Alexander
AU - Dahme, Tillman
AU - Rottner, Laura
AU - Sciacca, Vanessa
AU - Sieren, Malte Maria
AU - Jacob, Fabian
AU - Barkhausen, Jörg
AU - Sano, Makoto
AU - Eitel, Charlotte
AU - Metzner, Andreas
AU - Ouyang, Feifan
AU - Kuck, Karl Heinz
AU - Tilz, Roland Richard
AU - Heeger, Christian Hendrik
N1 - Funding Information:
Dr. Sommer has received lecture fees from Medtronic. Drs. Eitel, Metzner, Kuck, Tilz, and Heeger have received travel or research grant support from Medtronic. Dr. Kuck has received consulting fees from Medtronic, Boston Scientific, Biosense Webster, Abbott, and Edwards Lifesciences. Dr. Tilz has received presentation fees from Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Publisher Copyright:
© 2020 American College of Cardiology Foundation
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/7
Y1 - 2020/7
N2 - Objectives: This study sought to assess the incidence, procedural characteristics, contributing factors, and clinical outcome of cryoballoon-based pulmonary vein isolation (CB-PVI)–related hemoptysis in a multicenter study. Background: Hemoptysis has been described as a rare complication of CB-PVI. However, the precise mechanism and the etiology of this complication are poorly characterized. Methods: Consecutive patients undergoing CB-PVI for paroxysmal or persistent atrial fibrillation at 4 German hospitals were included in this observational analysis. Results: A total of 4,331 CB-PVI procedures were performed between 2006 and 2019. Fifteen patients (9 men, mean age 68.1 ± 9.8 years) developed acute hemoptysis during or within 24 h after CB-PVI, resulting in a hemoptysis frequency of 0.35%. Hemoptysis occurred in 6 of 720 procedures using the first-generation CB (0.83%) and in 9 of 3,611 procedures using the second-, third-, or fourth-generation CB (0.25%) (p = 0.015). Bronchoscopy was performed in 8 patients and showed bleeding exclusively due to mucosal injury or due to a coagulum at a bronchus adjacent to the ablation site. Hemoptysis resolved spontaneously without any long-term sequelae in all patients, except for a 92-year-old patient who died 13 days after CB-PVI due to pneumonia. No specific endobronchial treatment was necessary. Conclusions: Acute hemoptysis after CB-PVI is a rare but potentially life-threatening complication that is usually self-limiting. Direct thermal injury of bronchi adjacent to a pulmonary vein seems to be the most likely mechanism.
AB - Objectives: This study sought to assess the incidence, procedural characteristics, contributing factors, and clinical outcome of cryoballoon-based pulmonary vein isolation (CB-PVI)–related hemoptysis in a multicenter study. Background: Hemoptysis has been described as a rare complication of CB-PVI. However, the precise mechanism and the etiology of this complication are poorly characterized. Methods: Consecutive patients undergoing CB-PVI for paroxysmal or persistent atrial fibrillation at 4 German hospitals were included in this observational analysis. Results: A total of 4,331 CB-PVI procedures were performed between 2006 and 2019. Fifteen patients (9 men, mean age 68.1 ± 9.8 years) developed acute hemoptysis during or within 24 h after CB-PVI, resulting in a hemoptysis frequency of 0.35%. Hemoptysis occurred in 6 of 720 procedures using the first-generation CB (0.83%) and in 9 of 3,611 procedures using the second-, third-, or fourth-generation CB (0.25%) (p = 0.015). Bronchoscopy was performed in 8 patients and showed bleeding exclusively due to mucosal injury or due to a coagulum at a bronchus adjacent to the ablation site. Hemoptysis resolved spontaneously without any long-term sequelae in all patients, except for a 92-year-old patient who died 13 days after CB-PVI due to pneumonia. No specific endobronchial treatment was necessary. Conclusions: Acute hemoptysis after CB-PVI is a rare but potentially life-threatening complication that is usually self-limiting. Direct thermal injury of bronchi adjacent to a pulmonary vein seems to be the most likely mechanism.
UR - http://www.scopus.com/inward/record.url?scp=85083015608&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/63ed5b6f-1de8-3785-87ae-2386f3e0d2f5/
U2 - 10.1016/j.jacep.2020.02.003
DO - 10.1016/j.jacep.2020.02.003
M3 - Journal articles
C2 - 32703558
AN - SCOPUS:85083015608
SN - 2405-500X
VL - 6
SP - 773
EP - 782
JO - JACC: Clinical Electrophysiology
JF - JACC: Clinical Electrophysiology
IS - 7
ER -
