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The mitral valve complex: A complex trap to be avoided by cardiac electrophysiologists—A systematic review

Lookup NU author(s): Professor Bob Anderson

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Abstract

© 2025 Heart Rhythm SocietyCatheter entrapment within the mitral valve complex (MVC) is a rare but serious complication during left heart catheterization. A systematic review—the first on this topic—was conducted using PubMed and Embase databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, to identify cases of catheter entrapment within the MVC during electrophysiological procedures. Forty-six patients predominantly undergoing catheter ablation of atrial tachyarrhythmias (71.7%) were included. Circular mapping catheters were the most frequently entrapped materials (50%), followed by ablation and multispline catheters. Ablation catheters were mostly entrapped when advanced retrogradely, while multispline catheter entrapment was exclusively observed in patients with mechanical valves. Percutaneous management was successful in 47.8% of patients, one-third of whom required retrieval of embolized catheter segments. Surgery was necessary in 52.2% of patients, including valve surgery in 30.4%. Awareness of this potential complication and application of preventive strategies are essential when mapping or ablating adjacent to the MVC.

Publication metadata

Author(s): Ali H, Abdelrady Abdelsalam Farghaly A, Anderson RH, Lupo P, Foresti S, De Ambroggi G, Bessi R, Magnani S, Cappato R

Publication type: Review

Publication status: Published

Journal: Heart Rhythm

Year: 2025

Pages: epub ahead of print

Online publication date: 14/06/2025

Acceptance date: 02/04/2018

ISSN (print): 1547-5271

ISSN (electronic): 1556-3871

Publisher: Elsevier B.V.

URL: https://doi.org/10.1016/j.hrthm.2025.06.013

DOI: 10.1016/j.hrthm.2025.06.013

PubMed id: 40523459

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