20
Vagal nerve injury Vagal nerve injury is defined as injury to the vagal nerve that
results in esophageal dysmotility or gastroparesis. Vagal nerve
injury is considered to be a major complication if it prolongs
hospitalization, requires hospitalization, or results in ongoing
symptoms for more than 30 days following an ablation
procedure.
Vascular access
complication
Vascular access complications include development of a
hematoma, an AV fistula, or a pseudoaneurysm. A major vascular
complication is defined as one which requires intervention such
as surgical repair or transfusion, prolongs the hospital stay, or
requires hospital admission.
Table 7. Definitions of Complications Associated with AF
Ablation (cont'd)
Term Definition
Table 8. Incidence, Prevention, Diagnosis, and Treatment of
Selected Complications of AF Ablation
Complication Incidence
Selected
prevention
techniques
Diagnostic
testing
Selected
treatment
options
Air embolism <1% Sheath
management
Nothing
or cardiac
catheterization
Supportive
care with fluid,
oxygen, head
down tilt,
hyperbaric
oxygen
Asymptomatic
cerebral emboli
(ACE)
2% to
15%
Anticoagulation,
catheter and sheath
management, TEE
Brain MRI None
Atrialesophageal
fistula
0.02%
to 11%
Reduce power,
force, and RF
time on posterior
wall, monitor
esophageal temp,
use proton pump
inhibitors; avoid
energ y delivery
over esophagus
CT scan of
chest, MRI,
avoid endoscopy
with air
insufflation
Surgical repair
Treatment
