Cardiac tamponade: Development of a pericardial effusion that results in haemodynamic compromise or requires urgent pericardiocentesis. It usually occurs during the procedure, but can present many days or weeks later. |
Femoral vascular access complication: The commonest major complication. A haematoma, atrioventricular fistula or pseudoaneurysm requiring prolonged hospital stay, transfusion, percutaneous or surgical repair. |
Stroke or transient ischaemic attack: A new neurological deficit typically within 24 hours but the high-risk period is up to 2 weeks after ablation. |
Right phrenic nerve palsy: Common in cryoballoon ablation (5%). Absence of diaphragmatic movement during fluoroscopy as assessed by a sniff test. Rarely persists for more than 3 months and is usually asymptomatic. |
Pulmonary vein stenosis: A reduction of diameter of one or more pulmonary veins, causing haemoptysis, breathlessness or recurrent chest infection. A greater than 50% narrowing causing symptoms requires intervention. |
Atrio-oesophageal fistula: A rare but usually fatal consequence of ablation delivered to the posterior wall of the left atrium where, because of inflammation of the oesophagus, a connection forms. |