Electrophysiology Lab
This resource provides clear, easy-to-understand information for patients with pacemakers or implantable cardioverter-defibrillators (ICDs). It explains what to expect after device implantation, how to care for your incision, safety tips…
This document outlines a standardized protocol for safely performing MRI scans in patients with cardiac implantable electronic devices (CIEDs), including both MRI-conditional and legacy systems. It details eligibility criteria, device-specific…
These documents describe an IRB-approved research study and clinical safety workflow that allows patients with pacemakers/ICDs (CIEDs) to undergo clinically indicated MRI with standardized monitoring, device programming, and follow-up, while…
This patient-facing educational resource explains the Convergent Hybrid Ablation procedure for atrial fibrillation, a two-stage treatment option designed for patients with persistent or long-standing AF who continue to have symptoms…
The Anesthesia Checklist for EP Procedures provides a structured and safe approach for anesthesia management during electrophysiology (EP) procedures.
To ensure optimal care and outcomes for patients with atrial fibrillation, hospitals and electrophysiologists will need to take a systems-based approach to EP lab efficiency, focused on standardizing processes while…
Workflows: In collaboration with Anesthesia, Urology, PACU and EP, here is the bladder management workflow for ablation patients from the EP Lab.
Checklists: Checklist for care coordination for EPS/Ablation.
Checklists: Checklist to use when discharging and AFib patient same day.
Data/Registries: Aims: Oesophageal fistula represents a rare but dreadful complication of atrial fibrillation catheter ablation. Data on its incidence, management, and outcome are sparse. Methods and results: This international multicentre registry investigates the characteristics of oesophageal fistulae after treatment of atrial fibrillation by catheter ablation. A total of 553 729 catheter ablation procedures (radiofrequency: 62.9%, cryoballoon: 36.2%, other modalities: 0.9%) were performed, at 214 centres in 35 countries. In 78 centres 138 patients [0.025%, radiofrequency: 0.038%, cryoballoon: 0.0015% (P < 0.0001)] were diagnosed with an oesophageal fistula. Peri-procedural data were available for 118 patients (85.5%). Following catheter ablation, the median time to symptoms and the median time to diagnosis were 18 (7.75, 25; range: 0–60) days and 21 (15, 29.5; range: 2–63) days, respectively. The median time from symptom onset to oesophageal fistula diagnosis was 3 (1, 9; range: 0–42) days. The most common initial symptom was fever (59.3%). The diagnosis was established by chest computed tomography in 80.2% of patients. Oesophageal surgery was performed in 47.4% and direct endoscopic treatment in 19.8% and conservative treatment in 32.8% of patients. The overall mortality was 65.8%. Mortality following surgical (51.9%) or endoscopic treatment (56.5%) was significantly lower as compared to conservative management (89.5%) [odds ratio 7.463 (2.414, 23.072) P < 0.001]. Conclusion: Oesophageal fistula after catheter ablation of atrial fibrillation is rare and occurs mostly with the use of radiofrequency energyrather than cryoenergy. Mortality without surgical or endoscopic intervention is exceedingly high.