Cardiac tamponade during catheter-based ablation of cardiac arrhythmias: experience matters

Radiofrequency-based catheter ablation (RFCA) is a well-established therapeutic approach for a wide variety of arrhythmias. Over the years, complexity of catheter-based ablation procedures has progressively increased due to the inclusion of patients with more complex substrates and multiple comorbidities. The latter increases the possibility of serious adverse events, especially in the elderly (1,2). Many of the current electrophysiological substrates undergoing catheter ablation also require a transseptal puncture to achieve the left cardiac chambers, which increases complexity. One of the most serious complications during complex ablation substrates as atrial fibrillation (AF) and ventricular arrhythmia (VA) is cardiac tamponade, a life-threatening complication that represents the research topic of the recent study by Huang et al., published in Xiangya Medicine (3). The authors report their experience after more of 6,000 RFCA procedures performed during the last two decades in one center. The article describes the incidence of tamponade in different ablation substrates, along with the clinical diagnosis, treatment and prognosis.