23. “During an ablation, how much danger is there of developing a clot? What are the odds? How can these clots be prevented?” [Someone emailed me that she suffered both a stroke and a blood clot in her lung during her ablation. She is recovering. Why did this happen?]
Depending on how long one has been in A-Fib, clots may have developed in the heart, then be dislodged during the ablation.
Most centers do a TEE (Transesophageal Echocardiogram) before the ablation to check if there are any clots in your heart. If they find any, they administer anticoagulants to dissolve the clots before the ablation. If your center or doctor doesn’t plan to do a TEE before your ablation, you should probably go somewhere else.
However, most clots during an ablation come from RF charring. The heat from an RF catheter chars the heart tissue. Some of the char breaks off and becomes a clot. This problem has been minimized over the years by the use of irrigated tip catheters and the administering of heavy-duty anticoagulants like heparin during the ablation. The skill and expertise of the doctor also play an important role. But even in the best of hands, accidents can still happen.
Your chances of developing a clot during an ablation vary according to the institution and doctor. (You should ask about this the medical center or EP’s rate of clots forming when considering an ablation.) For example, the Bordeaux Group in 2010 reported an embolic event (stroke) rate of 0.2%.
With the newer technique of CryoBalloon (freezing) ablation, there is no charring and theoretically no risk of developing a clot from charring.
Last updated: Wednesday, February 4, 2015
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