Clinically Manifesting Air Embolisms in Cryoballoon Ablation: Can Novel Water Buckets Reduce the Risk?

JACC Clin Electrophysiol. 2020 Sep;6(9):1067-1072. doi: 10.1016/j.jacep.2020.07.012.

Abstract

Air embolisms can lead to lethal results; however, few reports have systemically investigated this issue. Of 348 consecutive patients with atrial fibrillation who underwent cryoballoon ablation, procedures were performed conventionally in 251 patients. In the remaining 97 patients, a water bucket was used while inserting the cryoballoon into the sheath. A total of 10 coronary air embolisms with ST-segment elevation in the inferior leads were observed among 9 (2.6%) patients. Multiple air bubbles were identified in 2 patients on emergent coronary angiography. All recovered under conservative treatment without any sequela. The incidence decreased when using the water bucket (1 of 97 [1.03%] vs. 8 of 251 [3.2%], p = 0.454).

Keywords: air embolism; atrial fibrillation; catheter ablation; complication; cryoballoon.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Atrial Fibrillation* / surgery
  • Catheter Ablation*
  • Cryosurgery* / adverse effects
  • Embolism, Air* / etiology
  • Embolism, Air* / prevention & control
  • Humans
  • Pulmonary Veins* / surgery
  • Treatment Outcome
  • Water

Substances

  • Water