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Avoiding Urinary Catheterization in Patients Undergoing Atrial Fibrillation Catheter Ablation

Purpose. Indwelling Urinary Catheters (IUC) are commonly inserted when administering general anesthesia. However, there are significant risks to routine IUC insertion. We compared urinary and other outcomes in a population of patients undergoing atrial fibrillation (AF) ablation with or without IUC. Methods. This was a single center, retrospective review of patients undergoing AF ablation.  Patients were identified by procedure codes and patient health characteristics and outcome data were manually extracted from electronic health records. The primary composite endpoint was 7-day periprocedural urinary outcomes including cystitis, dysuria, hematuria, urethral damage, or urinary retention. Results. 404 patients were included in the study, 297 with IUC and 107 without IUC. Uncatheterized patients were less likely to have congestive heart failure (CHF) (31.8% vs 43.4%; P = 0.039) and had a shorter procedure length (4.2 vs 4.9 hours; P < 0.001) with less fluid administered (1485 vs 2040 mL; P < 0.001).  No urinary complications occurred in the uncatheterized group versus 14 in the catheterized group (P = 0.026).  3 patients in the uncatheterized group developed serious infections versus none in the catheterized group (P = 0.018).  There was no incidence of death and no statistically significant difference in readmission in the 30 days after procedure. Conclusion. There were no urinary complications in 107 patients who received no IUC during AF ablation. Avoiding bladder catheters during AF ablation procedures may lower incidence of adverse urinary complications without adding substantial risk of urinary retention.

Credits: Andrew Lehman, Asim Ahmed, Parin Patel

Biosense Webster
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Introduction to AFib
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