Cardiac invasive electrophysiology studies with radiofrequency ablation without onsite cardiothoracic surgical back-up in a new cardiac electrophysiology laboratory : single-centre experience

ntroduction: Previous studies of invasive cardiac electrophysiology (EP) and radiofrequency catheter ablation (RFA) concluded that procedures can be safely performed successfully in selected groups of patients, by experienced staff, without on-site cardiothoracic surgery back-up. We aim to report a single centre experience. Methods and results: All consecutive patients (n = 57) who underwent cardiac EP studies and/or RFA at a cardiac EP laboratory, between 12 October 2016 and 13 December 2017 at Campbelltown Hospital in New South Wales, were evaluated. The cardiac EP laboratory was opened in October 2016 with one EP session per week. Patients who require complex RFA procedures such as pulmonary vein isolation for atrial fibrillation and ventricular tachycardia ablation were transferred to a nearby tertiary hospital. Median age was 57 years (interquartile range 39–54 years) and 63% were male. The indications and numbers of invasive EP studies and RFA are shown in the Figure 1. There were no access site complications, no major adverse cardiovascular events (death, stroke, major bleeding, perforation, tamponade, or complete heart block). No patients required emergency surgery. Conclusion: Cardiac EP studies with RFA are safely performed in certain indications for procedures without surgical back-up. Favourable clinical outcomes were obtained without complications during the first year experience. These results are consistent with the current published data.