Bladder Catheters During Ablation Procedures
Bladder Catheters During Ablation Procedures
Inserting a Bladder catheter during catheter ablation is standard practice at most
 Institutions. Unfortunately, bladder catheters are associated with adverse outcomes,
 including catheter associated cystitis, hematuria, dysuria, and urethral damage.

 The investigator proposes a prospective, randomized clinical trial comparing group A that
 will receive a catheter during the ablation procedure and group B that will not receive the
 procedure. The Investigator hypothesizes the group receiving the bladder catheters will have
 a higher rate of complications.
(AF) is the commonest arrhythmia worldwide and accounts for significant morbidity. The
 mainstay of treatment for drug refractory AF is catheter ablation. A preponderance of
 evidence indicates better outcomes when this procedure is performed under general anesthesia;
 this is standard of care at our institution. However, for a variety of reasons including long
 procedure time, procedural intravenous fluid administration, and prolonged bedrest following
 the procedure, standard of care at our institution and others is for bladder catheter
 placement during the procedure (4). Unfortunately, bladder catheters used during cardiac
 surgery have been associated with adverse outcomes, including catheter associated cystitis,
 hematuria, dysuria, and urethral damage(

 Fortunately, the landscape of AF ablation is changing rapidly, and procedure times are
 rapidly decreasing. Improvements in three dimensional mapping technology has allowed for less
 reliance on fluoroscopy and allows for real time visualization of ablation lesions.
 Improvements in ablation catheters have allowed for significantly reduced intravenous fluid
 administration during the procedure. The Site has also adopted an expedited protocol for
 venous hemostasis following the procedure that involves a figure-of-eight groin stitch,
 allowing for earlier mobility and a shorter bed rest following the procedure. Therefore, we
 question the need for routine bladder catheter placement during AF ablation procedures
Inclusion Criteria:

 -  All subjects presenting to the St. Vincent EP lab for AF ablation Ability to sign
 informed consent

 Exclusion Criteria:

 -  Recent (within 1 month) cystitis, history of urinary retention or incontinence, prior
 bladder catheter associated complications, hematuria, chronic kidney disease (stage
 II, III, IV, or V), dialysis, prostate cancer, renal cancer, bladder cancer, expected
 procedure duration >6 hours.