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B-PO03-120 ACUTE PERICARDITIS AFTER ATRIAL FIBRILLATION ABLATION: INCIDENCE, CHARACTERISTICS AND RISK FACTORS

      Background

      Acute pericarditis has been reported to occur after Atrial Fibrillation (AF) ablation; however, little is known about the characteristics of this patient population.

      Objective

      To describe the incidence, characteristics and risk factors of patients who underwent AF ablation in a large tertiary care center and went on to develop acute pericarditis.

      Methods

      All patients undergoing AF ablation in our center were enrolled in a prospectively maintained registry. Post AF ablation acute pericarditis was defined as pericardial chest pain treated with anti-inflammatories at the time of hospital discharge or within 3 months after AF ablation. Positive cases were identified using a prospectively maintained pharmacy database and verified by chart review.

      Results

      Of all patients (n=2128) undergoing AF ablation in our center from 2018-2019, 229 (10.3%) were identified as having acute pericarditis after their procedure. Baseline statistically significant characteristics in patients with pericarditis were younger age, lower CHADS2Vasc score, paroxysmal AF at the time of ablation and a higher BMI compared to patients without pericarditis. In a multivariable logistic regression model, a lower CHADS2Vasc score (OR 0.80 95% CI 0.71-0.91 p<0.01), higher BMI (OR 1.03 95% CI 1.00-1.05 P = 0.03), pre procedure use of Dofetilide (OR 1.56 95% CI 1.04-2.34 P=0.03) and Flecainide (OR 1.69, 95% CI 1.09-2.63, P=0.02) was associated with developing post procedure acute pericarditis. Within the pericarditis group, fever was present in 4%, post procedure effusion in 10.1%, pericarditic ECG changes in 19.6%. Median CRP was 3.4 (IQR 1.4-13.4) measured in 17 patients and median ESR was 8.5 (IQR 5-31) measured in 18 patients. Treatment choices included colchicine (64%), prednisone (29%) and Ibuprofen (19.2%). Multiple anti-inflammatory drug therapy was used in 27% of patients.

      Conclusion

      Acute pericarditis after AF ablation is under recognized and under reported. Younger patients with a higher BMI and fewer medical comorbidities appear to be at higher risk for developing this syndrome.