Entrapment of circular mapping catheter in the mitral valve

Background

Ablation procedures in the left atrium for treatment of atrial fibrillation are becoming increasingly common. The procedure often involves placing one or two circular mapping catheters in the left atrium. Entrapment of an ablation catheter in the mitral valve during ablations of left-sided accessory pathways by the retrograde approach has been described in two earlier published reports. More recently, several reports describe similar entrapment of a mapping catheter. In a recently published review, however, only one case of unspecified valve damage was registered among 8745 atrial fibrillation procedures.

Objective

The purpose of this study was to evaluate patients with entrapment.

Methods

Retrospective analysis of electrophysiological results.

Results

We describe three patients with entrapment during ablations for atrial fibrillation. The entrapments occurred with three different operators at three different electrophysiological laboratories within 2 years. The complication described here may be more common than is widely appreciated.

Conclusions

From our figures, we estimate the incidence of the complication to 0.9% (95% confidence interval, 0.2–2.5%).

Keywords: Catheter entrapment, Mitral valve, Ablation, Atrial fibrillation, Complication