Aims: Catheter ablation (CA) for atrial fibrillation (AF) has a considerable risk of procedural complications. Major vascular complications (MVCs) appear to be the most frequent. This study investigated gender differences in MVCs in patients undergoing CA for AF. Methods: A total of 4734 CAs for AF (65% paroxysmal, 26% repeated procedures) were performed at our center between January 2006 and August 2018. Patients (71% males) aged 60 ± 10 years and had body mass index of 29 ± 4 kg/m2. Radiofrequency point-by-point ablation was employed in 96.3% procedures with the use of 3D navigation systems and facilitated by intracardiac echocardiography. Pulmonary vein isolation was mandatory; cavotricuspid isthmus and left atrial substrate ablation were performed in 22% and 38% procedures, respectively. MVCs were defined as those that resulted in permanent injury, required intervention, or prolonged hospitalization. Their rates and risk factors were compared between genders. Results: A total of 112 (2.4%) MVCs were detected: 54/1512 (3.5%) in females and 58/3222 (1.8%) in males (P < 0.0001). On multivariate analysis, lower body height was the only risk factor for MVCs in females (P = 0.0005). On the contrary, advanced age was associated with MVCs in males (P = 0.006). Conclusion: Females have a higher risk of MVCs following CA for AF compared to males. This difference is driven by lower body size in females. Low body height in females and advanced age in males are independent predictors of MVCs. US-guided venipuncture lowered the MVC rate in males.

Background and aim of the study: Despite progressive improvement in perioperative care and device technology infectious complications (IC) remain one of the main causes worsening both short-term and long-term prognosis after long-term ventricular assist device (LVAD) implantation. The aim of this study was to assess procalcitonin (PCT) and presepsin (PSEP) dynamics after LVAD implantation and its relationship to IC in the early post-operative period. Methods: A total of 50 consecutive patients indicated to LVAD implantation were included. PCT and PSEP levels were prospectively assessed before surgery and during 30 day follow-up - 1st, 2nd, 14th and 30th post-operative day (POD). Values were compared according to the presence of IC. Results: Both PCT and PSEP levels raised significantly after LVAD implantation. There was no significant difference in PCT or PSEP levels between patients with or without IC during whole follow-up. Patients with acute renal failure (ARF) had significantly higher PCT levels 2 days after surgery and further. ARF increased PSEP levels significantly only 14 days after LVAD implantation. Also subjects with right ventricular assist device (RVAD) had higher PCT and PSEP values. This difference reached the significance only for PCT 14 days after surgery. Conclusions: Our data show that ability of PCT or PSEP to detect infectious complications in patients after LVAD implantation is limited. Their levels more likely correlate with severity of post-operative period in general.