Supplementary material
Table 8 Examples from literature on thromboembolic complications associated with right
side intervention (except atrial flutter)
Study
Population
studied
Anticoagulation
protocol
Hindricks
et al148
3937 patients
(AVNRT ,AV
junction
pathway
ablation)
Scheinman
n M.M149
2142 patients
with right sided
ablation
276 elderlyAVNRT ablation
No
information
regarding
periprocedur
al use of
anticoagulati
on
Various
Kihel et
al150
Epstein
M151
Arch Mal
Coeur
Vaiss152
Chen et
al153
Jan- Yow
Chen et
al.154
558 patients
with right sided
ablation
2765 patientsvarious ablation
procedures
2593
patients(3966
various ablation
procedures)
52 patients
(various
ablation
procedures and
electrophysiolo
gy study)
multiple
femoral sheats
vs single sheats
Rate of
systemic
complicatio
ns
3.2 %
Details
0.51%
3 cases (0.14%) of
thromboembolism(pulmon
ary or venous)
1 case of VT with PE
Heparin bolus 1.8%
2500U, then
1000 U/h
Various
0.04%
1 case cerebral embolism
(0.06%), 2 cases of
pulmonary embolism
(PE)(0.22%), and 9 cases of
venous thrombosis (VT)
(1.0)
3 cases of venous
thrombosis
Various
19 (0.3%)
8 cases of venous
thrombosis
Left sided:
heparin bolus
followed by
maintenance
infusion
Right sided:
no heparin
Left sided:
heparin bolus
followed by
maintenance
infusion
12 (0.4%)
3 cases of femoral artery
thrombosis and 1 case of
deep venous thrombosis
No
difference
in major
complicatio
ns
Non-occlusive DVT
appeared in 19.2% in
multiple femoral sheats vs
9.1% in single sheats
Ludek
Haman et
al.155
453 various
ablation
procedures for
supraventricula
r tachycardia in
400 patients,
transthoracic
echocardiograp
hy before and
after ablation
Abolfath
Alizadeh et
al.57
200 patients
with right heart
electrophysiolo
gy
study/ablation
procedure
V.
Davutoglu1
27 patients
with
electrophysiolo
gy study
56
Ahmad
544 patients
Yaminishar with AVNRT
if et al157.
ablation
G E O’Hara
et al.158
4373 patients
counting out
the ones with
ablation for
atrial flutter
Intravenous
heparin only
in left sided
RFA;
All patients
received
LMWH;
Antiplatelet
therapy after
the
procedure
and
continued for
1 month
Heparin
loading dose
of 5000U
then
monitoring
the activated
clotting time
vs no
anticoagulati
on
Not
reported
Thrombotic complications
in 7 cases (1.75%) 4 of
them asymptomatic:
thrombus in right atrium,
thrombus in inferior vena
cava, DVT with massive PE,
femoral vein thrombosis
and upper extremity digital
artery embolization
0
1 case of superficial
thrombophlebitis, and no
DVT.
Randomized
in two
groups:
5000 U
dalteparin vs
no
anticoagulant
Bolus 5000
units of
heparin
0
None of the patients had
clinical DVT or PE. Reduced
rate of in situ thromobosis
in the dalteparin group
4.5%
3 patients developed DVT
No
information
regarding
periprocedur
al use of
anticoagulati
on
1.6%
3 cases of PE (0.13%) and
one case of DVT (0.09%)
Min-Ji
Charng et
al. 159
Evaluation of
platelet and
hemostatic
activation in
right(24 pt) vs
left heart
ablation (20 pt)
Patients with
antiplatelet
or
anticoagulant
were
excluded
Not
reported
No clinically symptomatic
thromboembolism, no
difference in hemostatic
and platelet activation
levels
Eloi
Marijon et
al.160
1342 patients
with various
ablation
procedures for
supraventricula
r tachycardia
1000 UI bolus
of heparin
followed by
1000 UI
infusion
0.63%
2 cases of pulmonary
embolism
Petr
Parizek et
al. 161
60 patients
with right sided
ablation for
supraventricula
r tachycardia
220 patients
No
anticoagulati
on
Not
reported
No clinical
thromboembolic
complications were noted
Ghassan
Moubarak
et al58.
Various
11 (5%) cases of
asymptomatic femoral
DVT.