Percutaneous electrophysiologic studies may be associated with a number of complications. Most complications are rare provided patients are adequately evaluated prior to the procedure.


Thrombo-embolic complications:

(1) thrombophlebitis

(2) pulmonary embolism

(3) acute myocardial infarction (see contraindications in section)

(4) stroke (rare)


Hemorrhagic or traumatic complications:

(1) associated with arterial tear

(2) myocardial perforation with pericardial tamponade

(3) pneumothorax


Complications of radiofrequency ablation:

(1) complete heart block


Other complications:

(1) plexopathy

(2) cardiac arrhythmias

(3) death (very rare)


Risk for complications are increased with:

(1) anticoagulation or bleeding disorder (hemorrhagic complications)

(2) hypercoagulable state (thrombo-embolic complications)

(3) myocardial disease (thin wall, soft myocardium, other)

(4) severe coronary artery disease, especially involving the left main coronary artery (contraindication)

(5) severe electrolyte imbalances (contraindication)

(6) severe aortic stenosis (contraindication)

(7) malfunctioning of equipment, especially during radiofrequency ablation

(8) technical difficulty (associated with operator experience, anatomic difficulties, etc)

(9) intra-atrial or intra-ventricular thrombus material


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