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Early Cerebral Thromboembolic Complications following Radiofrequency Catheter Ablation of Atrial Fibrillation: Incidence, Characteristics and Risk Factors.
MedLine Citation:
PMID:  25086257     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Thromboembolic complications remain one of the most severe adverse events associated with catheter ablation of atrial fibrillation (AF) but there are limited data on those events.
OBJECTIVE: The aim of this study was to evaluate the incidence, characteristics and risk factors of thromboembolic complications after AF ablation.
METHODS: Cerebral thromboembolic complications within one month following 3360 consecutive AF radiofrequency catheter ablations were assessed. Stroke was defined as a neurologic deficit lasting more than 24 hours or with imaging study showing new infarction. Transient ischemic attack (TIA) was defined as a deficit lasting less than 24 hours and without documented infarction.
RESULTS: There were 17 peri-interventional cerebral thromboembolic events (0.5%). Nine cases were diagnosed as strokes (53%) and 8 as TIAs (47%). Sixty percent of the events occurred within 48 hours after the ablation and the rest within one week. In univariate analysis, peri-interventional thromboembolism was associated with peripheral vascular disease (p=0.010), impaired left ventricular ejection fraction (p=0.040), peri-procedural bridging with heparin (p=0.007) and previous stroke (p=0.026). Multivariable analysis demonstrated that peripheral vascular disease (OR 8.81, CI 1.61-48.31, p=0.012) and previous stroke (OR 6.13, CI 1.18-31.91, p=0.031) were independent predictors. In a different model, the CHA2DS2-VASc score was associated with thromboembolism (OR 1.35, CI 1.00-1.80, p=0.049).
CONCLUSIONS: Cerebral thromboembolic complications after AF radiofrequency catheter ablation are rare. They mostly occur within 48 hours after the procedure and remain without lasting neurological deficits in the majority of cases. Such complications are associated with peripheral vascular disease, previous stroke and the CHA2DS2-VASc score.
Authors:
Jedrzej Kosiuk; Jelena Kornej; Andreas Bollmann; Christopher Piorkowski; Krzysztof Myrda; Arash Arya; Philipp Sommer; Sergio Richter; Sascha Rolf; Daniela Husser; Thomas Gaspar; Gregory Y H Lip; Gerhard Hindricks
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-30
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-8-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014. Published by Elsevier Inc.
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