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Catheter and Surgical Ablation of Atrial Fibrillation

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22 Permanent phrenic nerve paralysis 0% to 0.4% Monitor diaphragm during phrenic pacing, CMAP monitoring, phrenic pacing to identify location and adjust lesion location CXR, sniff test Supportive care Pulmonary vein stenosis <1% Avoid energ y delivery within PV CT or MRI, V/Q wave scan Angioplasty, stent, surgery Radiation injury <0.1% Minimize fluoroscopy exposure especially in obese and repeat ablation patients, X-ray equipment None Supportive care, rarely skin gra Stiff le atrial syndrome <1.5% Limit extent of le atrial ablation Echocardiography, cardiac catheterization Diuretics Stroke and TIA 0% to 2% Pre-, post-, and intraprocedure anticoagulation, catheter and sheath management, TEE Head CT or MRI, cerebral angiography rombolytic therapy, angioplasty Vascular complications 0.2% to 1.5% Vascular access techniques, ultrasound guided access, anticoagulation management Vascular ultrasound, CT scan Conservative treatment, surgical repair, transfusion Table 8. Incidence, Prevention, Diagnosis, and Treatment of Selected Complications of AF Ablation (cont'd) Complication Incidence Selected prevention techniques Diagnostic testing Selected treatment options Treatment

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