Document Detail


Radiofrequency catheter ablation of atrial fibrillation: a cause of silent thromboembolism? Magnetic resonance imaging assessment of cerebral thromboembolism in patients undergoing ablation of atrial fibrillation.
MedLine Citation:
PMID:  20937975     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Radiofrequency left atrial catheter ablation has become a routine procedure for treatment of atrial fibrillation. The aim of this study was to assess with preprocedural and postprocedural cerebral magnetic resonance imaging the thromboembolic risk, either silent or clinically manifest, in the context of atrial fibrillation ablation. The secondary end point was the identification of clinical or procedural parameters that correlate with cerebral embolism. METHODS AND RESULTS: A total of 232 consecutive patients with paroxysmal or persistent atrial fibrillation who were candidates for radiofrequency left atrial catheter ablation were included in the study. Pulmonary vein isolation or pulmonary vein isolation plus linear lesions plus atrial defragmentation with the use of irrigated-tip ablation catheters was performed. All of the patients underwent preprocedural and postablation cerebral magnetic resonance imaging. A periprocedural symptomatic cerebrovascular accident occurred in 1 patient (0.4). Postprocedural cerebral magnetic resonance imaging was positive for new embolic lesions in 33 patients (14). No clinical parameters such as age, hypertension, diabetes mellitus, previous history of stroke, type of atrial fibrillation, and preablation antithrombotic treatment showed significant correlation with ischemic cerebral embolism. Procedural parameters such as activated clotting time value and, in particular, electric or pharmacological cardioversion to sinus rhythm correlated with an increased incidence of cerebral embolism. Cardioversion was also associated with an increased risk of 2.75 (95 confidence interval, 1.29 to 5.89; P=0.009). CONCLUSIONS: Radiofrequency left atrial catheter ablation carries a low risk of symptomatic cerebral ischemia but is associated with a substantial risk of silent cerebral ischemia detected on magnetic resonance imaging. Independent risk factors for cerebral thromboembolism are the level of activated clotting time and, in particular, the electric or pharmacological cardioversion to sinus rhythm during the procedure.
Authors:
Fiorenzo Gaita; Domenico Caponi; Martina Pianelli; Marco Scaglione; Elisabetta Toso; Federico Cesarani; Carlo Boffano; Giovanni Gandini; Maria Consuelo Valentini; Roberto De Ponti; Franck Halimi; Jean François Leclercq
Related Documents :
19531455 - Tumour characteristics and therapeutic results after percutaneous radiofrequency ablati...
17180325 - Adrenal metastases: ct-guided and mr-thermometry-controlled laser-induced interstitial ...
18175165 - Diagnostic performance of contrast-enhanced computed tomography in the immediate assess...
11930075 - Hepatic tumors treated with percutaneous radio-frequency ablation: ct and mr imaging fo...
23433475 - Surgical management of a giant cervical ganglioneuroma.
23887285 - What is the predictive value of mri for the occurrence of knee replacement surgery in k...
Publication Detail:
Type:  Journal Article     Date:  2010-10-11
Journal Detail:
Title:  Circulation     Volume:  122     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1667-73     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, School of Medicine, Cardinal Massaia Hospital, University of Turin, Asti, Italy. gaitaf@libero.it
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Comments/Corrections
Comment In:
Circulation. 2010 Oct 26;122(17):1662-3   [PMID:  20937971 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Vascular Endothelial Growth Factor-B Acts as a Coronary Growth Factor in Transgenic Rats Without Ind...
Next Document:  Multimarker approach for the prediction of heart failure incidence in the community.