Effect of Catheter Ablation and Periprocedural Anticoagulation Regimen on the Clinical Course of Migraine in Atrial Fibrillation Patients With or Without Pre-Existent Migraine: Results From a Prospective Study
BACKGROUND—We examined the influence of catheter ablation and periprocedural anticoagulation regimen on trajectory of migraine in atrial fibrillation patients with or without migraine history. METHODS AND RESULTS—Forty patients with (group 164±8 years; men 78%) and 85 (group 261±10 years; men 73%) w...
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| creator | Mohanty, Sanghamitra Mohanty, Prasant Rutledge, J Neal Di Biase, Luigi Yan, Rachel Xue Trivedi, Chintan Santangeli, Pasquale Bai, Rong Cardinal, Deb Burkhardt, J David Gallinghouse, Joseph G Horton, Rodney Sanchez, Javier E Bailey, Shane Hranitzky, Patrick M Zagrodzky, Jason Al-Ahmad, Amin Natale, Andrea |
| description | BACKGROUND—We examined the influence of catheter ablation and periprocedural anticoagulation regimen on trajectory of migraine in atrial fibrillation patients with or without migraine history.
METHODS AND RESULTS—Forty patients with (group 164±8 years; men 78%) and 85 (group 261±10 years; men 73%) without migraine history undergoing atrial fibrillation-ablation were enrolled. Migraine status and quality of life were evaluated using standardized questionnaires. Diffusion magnetic resonance imaging of brain was performed for all at pre and 24 hours post procedure. Catheter ablation was performed with (88, 70%) or without (37, 30%) continuous warfarin treatment. Fifty-four patients (11 and 43 from groups 1 and 2, respectively) had subtherapeutic international normalized ratio on procedure day. At 17±5 months follow-up, from group 1, 25 (63%) reported no migraine, 10 (25%) had |
| doi_str_mv | 10.1161/CIRCEP.114.002285 |
| format | Article |
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METHODS AND RESULTS—Forty patients with (group 164±8 years; men 78%) and 85 (group 261±10 years; men 73%) without migraine history undergoing atrial fibrillation-ablation were enrolled. Migraine status and quality of life were evaluated using standardized questionnaires. Diffusion magnetic resonance imaging of brain was performed for all at pre and 24 hours post procedure. Catheter ablation was performed with (88, 70%) or without (37, 30%) continuous warfarin treatment. Fifty-four patients (11 and 43 from groups 1 and 2, respectively) had subtherapeutic international normalized ratio on procedure day. At 17±5 months follow-up, from group 1, 25 (63%) reported no migraine, 10 (25%) had <1, and 3 (8%) had 2 to 3 monthly symptoms. Intensity of pain decreased from baseline 7 (Q1–Q3, 4–8) to 2 (0–4) scale points at follow-up (P<0.001) and duration of headache from median 8 (Q1–Q3, 4–15) to 0.5 (Q1–Q3, 0–2) hours (P<0.001). Two patients from group 1 reported increased migraine severity and 2 from group 2 had new-onset migraine. Follow-up diffusion magnetic resonance imaging revealed new infarcts in 9.6% (12/125) patients; of which 11 had subtherapeutic preprocedural international normalized ratio on or off continuous warfarin. Quality of life improved significantly in patients with successful ablation, being more pronounced in group 1.
CONCLUSIONS—In most patients, migraine symptoms improved substantially after catheter ablation. Interestingly, the only cases of new migraine and aggravation of pre-existent headache had subtherapeutic international normalized ratio during the procedure and new cerebral infarcts.</description><identifier>ISSN: 1941-3149</identifier><identifier>EISSN: 1941-3084</identifier><identifier>DOI: 10.1161/CIRCEP.114.002285</identifier><identifier>PMID: 25682124</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Aged ; Anticoagulants - administration & dosage ; Anticoagulants - adverse effects ; Atrial Fibrillation - complications ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - therapy ; Catheter Ablation - adverse effects ; Diffusion Magnetic Resonance Imaging ; Drug Administration Schedule ; Female ; Humans ; International Normalized Ratio ; Male ; Middle Aged ; Migraine Disorders - complications ; Migraine Disorders - diagnosis ; Predictive Value of Tests ; Prospective Studies ; Quality of Life ; Recurrence ; Severity of Illness Index ; Surveys and Questionnaires ; Time Factors ; Treatment Outcome ; Warfarin - administration & dosage ; Warfarin - adverse effects</subject><ispartof>Circulation. Arrhythmia and electrophysiology, 2015-04, Vol.8 (2), p.279-287</ispartof><rights>2015 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2295-aae5db719889c8e49fe0738d22475415f3f865b487f888212ca9e34f799f76313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25682124$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mohanty, Sanghamitra</creatorcontrib><creatorcontrib>Mohanty, Prasant</creatorcontrib><creatorcontrib>Rutledge, J Neal</creatorcontrib><creatorcontrib>Di Biase, Luigi</creatorcontrib><creatorcontrib>Yan, Rachel Xue</creatorcontrib><creatorcontrib>Trivedi, Chintan</creatorcontrib><creatorcontrib>Santangeli, Pasquale</creatorcontrib><creatorcontrib>Bai, Rong</creatorcontrib><creatorcontrib>Cardinal, Deb</creatorcontrib><creatorcontrib>Burkhardt, J David</creatorcontrib><creatorcontrib>Gallinghouse, Joseph G</creatorcontrib><creatorcontrib>Horton, Rodney</creatorcontrib><creatorcontrib>Sanchez, Javier E</creatorcontrib><creatorcontrib>Bailey, Shane</creatorcontrib><creatorcontrib>Hranitzky, Patrick M</creatorcontrib><creatorcontrib>Zagrodzky, Jason</creatorcontrib><creatorcontrib>Al-Ahmad, Amin</creatorcontrib><creatorcontrib>Natale, Andrea</creatorcontrib><title>Effect of Catheter Ablation and Periprocedural Anticoagulation Regimen on the Clinical Course of Migraine in Atrial Fibrillation Patients With or Without Pre-Existent Migraine: Results From a Prospective Study</title><title>Circulation. Arrhythmia and electrophysiology</title><addtitle>Circ Arrhythm Electrophysiol</addtitle><description>BACKGROUND—We examined the influence of catheter ablation and periprocedural anticoagulation regimen on trajectory of migraine in atrial fibrillation patients with or without migraine history.
METHODS AND RESULTS—Forty patients with (group 164±8 years; men 78%) and 85 (group 261±10 years; men 73%) without migraine history undergoing atrial fibrillation-ablation were enrolled. Migraine status and quality of life were evaluated using standardized questionnaires. Diffusion magnetic resonance imaging of brain was performed for all at pre and 24 hours post procedure. Catheter ablation was performed with (88, 70%) or without (37, 30%) continuous warfarin treatment. Fifty-four patients (11 and 43 from groups 1 and 2, respectively) had subtherapeutic international normalized ratio on procedure day. At 17±5 months follow-up, from group 1, 25 (63%) reported no migraine, 10 (25%) had <1, and 3 (8%) had 2 to 3 monthly symptoms. Intensity of pain decreased from baseline 7 (Q1–Q3, 4–8) to 2 (0–4) scale points at follow-up (P<0.001) and duration of headache from median 8 (Q1–Q3, 4–15) to 0.5 (Q1–Q3, 0–2) hours (P<0.001). Two patients from group 1 reported increased migraine severity and 2 from group 2 had new-onset migraine. Follow-up diffusion magnetic resonance imaging revealed new infarcts in 9.6% (12/125) patients; of which 11 had subtherapeutic preprocedural international normalized ratio on or off continuous warfarin. Quality of life improved significantly in patients with successful ablation, being more pronounced in group 1.
CONCLUSIONS—In most patients, migraine symptoms improved substantially after catheter ablation. Interestingly, the only cases of new migraine and aggravation of pre-existent headache had subtherapeutic international normalized ratio during the procedure and new cerebral infarcts.</description><subject>Aged</subject><subject>Anticoagulants - administration & dosage</subject><subject>Anticoagulants - adverse effects</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - therapy</subject><subject>Catheter Ablation - adverse effects</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Drug Administration Schedule</subject><subject>Female</subject><subject>Humans</subject><subject>International Normalized Ratio</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Migraine Disorders - complications</subject><subject>Migraine Disorders - diagnosis</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Quality of Life</subject><subject>Recurrence</subject><subject>Severity of Illness Index</subject><subject>Surveys and Questionnaires</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Warfarin - administration & dosage</subject><subject>Warfarin - adverse effects</subject><issn>1941-3149</issn><issn>1941-3084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9u1DAQxi0EoqXwAFyQj1xS4sRJHG6raBcqFbEqII6R44x3DYm9-E9LH5M3YpZse-RgzSfNbz57_BHymuWXjNXsXXd10623qPllnheFqJ6Qc9ZylpW54E8fNOPtGXkRwo88r5lg9XNyVlS1KFjBz8mftdagInWadjLuIYKnq2GS0ThLpR3pFrw5eKdgTF5OdGWjUU7u0gm5gZ2ZwVKUOE27yVijkOtc8gGOtp_MzktjgRpLV9EbbG7M4M10cthiARsD_W7injr_r7oU6dZDtv5tQsTuo8t7vDGkCfGNdzOVSLlwwA3MLdAvMY33L8kzLacAr071gnzbrL92H7Przx-uutV1poqirTIpoRqHhrVCtEoAbzXkTSnGouBNxVmlSy3qauCi0UIcP0vJFkqum7bVTV2y8oK8XXzxd34lCLGfTVCAa1lwKfSsbio8GAWibEEVPjZ40P3Bm1n6-57l_THJfkkSNe-XJHHmzck-DTOMjxMP0SFQLcCdmzC18HNKd-D7Pcgp7v9j_Bd0sq34</recordid><startdate>201504</startdate><enddate>201504</enddate><creator>Mohanty, Sanghamitra</creator><creator>Mohanty, Prasant</creator><creator>Rutledge, J Neal</creator><creator>Di Biase, Luigi</creator><creator>Yan, Rachel Xue</creator><creator>Trivedi, Chintan</creator><creator>Santangeli, Pasquale</creator><creator>Bai, Rong</creator><creator>Cardinal, Deb</creator><creator>Burkhardt, J David</creator><creator>Gallinghouse, Joseph G</creator><creator>Horton, Rodney</creator><creator>Sanchez, Javier E</creator><creator>Bailey, Shane</creator><creator>Hranitzky, Patrick M</creator><creator>Zagrodzky, Jason</creator><creator>Al-Ahmad, Amin</creator><creator>Natale, Andrea</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201504</creationdate><title>Effect of Catheter Ablation and Periprocedural Anticoagulation Regimen on the Clinical Course of Migraine in Atrial Fibrillation Patients With or Without Pre-Existent Migraine: Results From a Prospective Study</title><author>Mohanty, Sanghamitra ; Mohanty, Prasant ; Rutledge, J Neal ; Di Biase, Luigi ; Yan, Rachel Xue ; Trivedi, Chintan ; Santangeli, Pasquale ; Bai, Rong ; Cardinal, Deb ; Burkhardt, J David ; Gallinghouse, Joseph G ; Horton, Rodney ; Sanchez, Javier E ; Bailey, Shane ; Hranitzky, Patrick M ; Zagrodzky, Jason ; Al-Ahmad, Amin ; Natale, Andrea</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2295-aae5db719889c8e49fe0738d22475415f3f865b487f888212ca9e34f799f76313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Anticoagulants - administration & dosage</topic><topic>Anticoagulants - adverse effects</topic><topic>Atrial Fibrillation - complications</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - therapy</topic><topic>Catheter Ablation - adverse effects</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Drug Administration Schedule</topic><topic>Female</topic><topic>Humans</topic><topic>International Normalized Ratio</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Migraine Disorders - complications</topic><topic>Migraine Disorders - diagnosis</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Quality of Life</topic><topic>Recurrence</topic><topic>Severity of Illness Index</topic><topic>Surveys and Questionnaires</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Warfarin - administration & dosage</topic><topic>Warfarin - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mohanty, Sanghamitra</creatorcontrib><creatorcontrib>Mohanty, Prasant</creatorcontrib><creatorcontrib>Rutledge, J Neal</creatorcontrib><creatorcontrib>Di Biase, Luigi</creatorcontrib><creatorcontrib>Yan, Rachel Xue</creatorcontrib><creatorcontrib>Trivedi, Chintan</creatorcontrib><creatorcontrib>Santangeli, Pasquale</creatorcontrib><creatorcontrib>Bai, Rong</creatorcontrib><creatorcontrib>Cardinal, Deb</creatorcontrib><creatorcontrib>Burkhardt, J David</creatorcontrib><creatorcontrib>Gallinghouse, Joseph G</creatorcontrib><creatorcontrib>Horton, Rodney</creatorcontrib><creatorcontrib>Sanchez, Javier E</creatorcontrib><creatorcontrib>Bailey, Shane</creatorcontrib><creatorcontrib>Hranitzky, Patrick M</creatorcontrib><creatorcontrib>Zagrodzky, Jason</creatorcontrib><creatorcontrib>Al-Ahmad, Amin</creatorcontrib><creatorcontrib>Natale, Andrea</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mohanty, Sanghamitra</au><au>Mohanty, Prasant</au><au>Rutledge, J Neal</au><au>Di Biase, Luigi</au><au>Yan, Rachel Xue</au><au>Trivedi, Chintan</au><au>Santangeli, Pasquale</au><au>Bai, Rong</au><au>Cardinal, Deb</au><au>Burkhardt, J David</au><au>Gallinghouse, Joseph G</au><au>Horton, Rodney</au><au>Sanchez, Javier E</au><au>Bailey, Shane</au><au>Hranitzky, Patrick M</au><au>Zagrodzky, Jason</au><au>Al-Ahmad, Amin</au><au>Natale, Andrea</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Catheter Ablation and Periprocedural Anticoagulation Regimen on the Clinical Course of Migraine in Atrial Fibrillation Patients With or Without Pre-Existent Migraine: Results From a Prospective Study</atitle><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle><addtitle>Circ Arrhythm Electrophysiol</addtitle><date>2015-04</date><risdate>2015</risdate><volume>8</volume><issue>2</issue><spage>279</spage><epage>287</epage><pages>279-287</pages><issn>1941-3149</issn><eissn>1941-3084</eissn><abstract>BACKGROUND—We examined the influence of catheter ablation and periprocedural anticoagulation regimen on trajectory of migraine in atrial fibrillation patients with or without migraine history.
METHODS AND RESULTS—Forty patients with (group 164±8 years; men 78%) and 85 (group 261±10 years; men 73%) without migraine history undergoing atrial fibrillation-ablation were enrolled. Migraine status and quality of life were evaluated using standardized questionnaires. Diffusion magnetic resonance imaging of brain was performed for all at pre and 24 hours post procedure. Catheter ablation was performed with (88, 70%) or without (37, 30%) continuous warfarin treatment. Fifty-four patients (11 and 43 from groups 1 and 2, respectively) had subtherapeutic international normalized ratio on procedure day. At 17±5 months follow-up, from group 1, 25 (63%) reported no migraine, 10 (25%) had <1, and 3 (8%) had 2 to 3 monthly symptoms. Intensity of pain decreased from baseline 7 (Q1–Q3, 4–8) to 2 (0–4) scale points at follow-up (P<0.001) and duration of headache from median 8 (Q1–Q3, 4–15) to 0.5 (Q1–Q3, 0–2) hours (P<0.001). Two patients from group 1 reported increased migraine severity and 2 from group 2 had new-onset migraine. Follow-up diffusion magnetic resonance imaging revealed new infarcts in 9.6% (12/125) patients; of which 11 had subtherapeutic preprocedural international normalized ratio on or off continuous warfarin. Quality of life improved significantly in patients with successful ablation, being more pronounced in group 1.
CONCLUSIONS—In most patients, migraine symptoms improved substantially after catheter ablation. Interestingly, the only cases of new migraine and aggravation of pre-existent headache had subtherapeutic international normalized ratio during the procedure and new cerebral infarcts.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>25682124</pmid><doi>10.1161/CIRCEP.114.002285</doi><tpages>9</tpages></addata></record> |
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| ispartof | Circulation. Arrhythmia and electrophysiology, 2015-04, Vol.8 (2), p.279-287 |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Anticoagulants - administration & dosage Anticoagulants - adverse effects Atrial Fibrillation - complications Atrial Fibrillation - diagnosis Atrial Fibrillation - therapy Catheter Ablation - adverse effects Diffusion Magnetic Resonance Imaging Drug Administration Schedule Female Humans International Normalized Ratio Male Middle Aged Migraine Disorders - complications Migraine Disorders - diagnosis Predictive Value of Tests Prospective Studies Quality of Life Recurrence Severity of Illness Index Surveys and Questionnaires Time Factors Treatment Outcome Warfarin - administration & dosage Warfarin - adverse effects |
| title | Effect of Catheter Ablation and Periprocedural Anticoagulation Regimen on the Clinical Course of Migraine in Atrial Fibrillation Patients With or Without Pre-Existent Migraine: Results From a Prospective Study |
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