Incidence and predictors of silent cerebral embolism during pulmonary vein catheter ablation for atrial fibrillation
Aims Left atrial catheter ablation of the pulmonary veins (PV) has evolved as an important therapeutic option for the treatment of atrial fibrillation (AF). We aimed to investigate the incidence and predictors of silent cerebral embolism associated with PV catheter ablation, detected by diffusion-we...
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| Veröffentlicht in: | Europace (London, England) England), 2010-01, Vol.12 (1), p.52-57 |
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| creator | Schrickel, Jan Wilko Lickfett, Lars Lewalter, Thorsten Mittman-Braun, Erica Selbach, Stephanie Strach, Katharina Nähle, Claas P. Schwab, Jörg Otto Linhart, Markus Andrié, Rene Nickenig, Georg Sommer, Torsten |
| description | Aims
Left atrial catheter ablation of the pulmonary veins (PV) has evolved as an important therapeutic option for the treatment of atrial fibrillation (AF). We aimed to investigate the incidence and predictors of silent cerebral embolism associated with PV catheter ablation, detected by diffusion-weighted magnetic resonance imaging (DW-MRI).
Methods and results
We performed a prospective analysis of 53 consecutive patients with persistent or paroxysmal AF that underwent PV ablation and post-procedural cerebral MRI 1 day after lasso catheter-guided ostial PV ablation. Patients were analysed for possible demographical, medical, echocardiographical, and procedural predictors of embolic events. A mean of 3.5 ± 0.5 PVs were ablated per patient. In six patients, DW-MRI depicted new clinically silent microembolism after PV ablation (11%). The number of ineffective medical antiarrhythmic agents prior to ablation procedure was significantly higher in the embolism group (3.3 ± 0.5 vs. 2.2 ± 1.4, P = 0.014). Coronary heart disease (CAD) was more frequent in patients with cerebral embolisms (33 vs. 2%, P = 0.031); left ventricular volume (130 ± 12 vs. 103 ± 26 mL, P = 0.002), and septal wall thickness (13.0 ± 1.4 vs. 7.9 ± 4.8 mm, P = 0.025) were significantly increased.
Conclusion
This study shows a high incidence of silent micro-embolic events after PV ablation. CAD, left ventricular dilatation, and hypertrophy were potential predictors of this complication. |
| doi_str_mv | 10.1093/europace/eup350 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_TOX</sourceid><recordid>TN_cdi_proquest_miscellaneous_734194760</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/europace/eup350</oup_id><sourcerecordid>734194760</sourcerecordid><originalsourceid>FETCH-LOGICAL-c471t-41f5b783b1f03b231772efa47dfb0e30975620f00c72cc16558bd728d0af34933</originalsourceid><addsrcrecordid>eNqFkc1rFjEQxoMotlbPvUluFmHtJNm82RxLqVooeNHzkmQnbWQ3WZOs4H_flH3FWz3NB795mJmHkHMGnxhocYlbTqtx2JJVSHhBTpkUvOOg-cuWg9adZFyfkDel_AQAxbV8TU6Y1kJIpk5JvY0uTBgdUhMnumacgqspF5o8LWHGWKnDjDabmeJi0xzKQqcth3hP121eUjT5D_2NIVJn6gNWzNTY2dSQIvWpFTWHNuuDzWHe-2_JK2_mgu-O8Yz8-Hzz_fprd_fty-311V3nesVq1zMvrRqEZR6E5YIpxdGbXk3eAgrQSh44eACnuHPsIOVgJ8WHCYwXfbvwjHzYddecfm1Y6riE4rBtETFtZVSiZ7pXB2jkxbMk6_VhGFSvZUMvd9TlVEpGP645LO0JI4PxyZTxrynjbkqbeH8U3-yC0z_-6EIDPu5A2tb_qj0CdSKbZg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1496887495</pqid></control><display><type>article</type><title>Incidence and predictors of silent cerebral embolism during pulmonary vein catheter ablation for atrial fibrillation</title><source>Oxford Journals Open Access Collection</source><creator>Schrickel, Jan Wilko ; Lickfett, Lars ; Lewalter, Thorsten ; Mittman-Braun, Erica ; Selbach, Stephanie ; Strach, Katharina ; Nähle, Claas P. ; Schwab, Jörg Otto ; Linhart, Markus ; Andrié, Rene ; Nickenig, Georg ; Sommer, Torsten</creator><creatorcontrib>Schrickel, Jan Wilko ; Lickfett, Lars ; Lewalter, Thorsten ; Mittman-Braun, Erica ; Selbach, Stephanie ; Strach, Katharina ; Nähle, Claas P. ; Schwab, Jörg Otto ; Linhart, Markus ; Andrié, Rene ; Nickenig, Georg ; Sommer, Torsten</creatorcontrib><description>Aims
Left atrial catheter ablation of the pulmonary veins (PV) has evolved as an important therapeutic option for the treatment of atrial fibrillation (AF). We aimed to investigate the incidence and predictors of silent cerebral embolism associated with PV catheter ablation, detected by diffusion-weighted magnetic resonance imaging (DW-MRI).
Methods and results
We performed a prospective analysis of 53 consecutive patients with persistent or paroxysmal AF that underwent PV ablation and post-procedural cerebral MRI 1 day after lasso catheter-guided ostial PV ablation. Patients were analysed for possible demographical, medical, echocardiographical, and procedural predictors of embolic events. A mean of 3.5 ± 0.5 PVs were ablated per patient. In six patients, DW-MRI depicted new clinically silent microembolism after PV ablation (11%). The number of ineffective medical antiarrhythmic agents prior to ablation procedure was significantly higher in the embolism group (3.3 ± 0.5 vs. 2.2 ± 1.4, P = 0.014). Coronary heart disease (CAD) was more frequent in patients with cerebral embolisms (33 vs. 2%, P = 0.031); left ventricular volume (130 ± 12 vs. 103 ± 26 mL, P = 0.002), and septal wall thickness (13.0 ± 1.4 vs. 7.9 ± 4.8 mm, P = 0.025) were significantly increased.
Conclusion
This study shows a high incidence of silent micro-embolic events after PV ablation. CAD, left ventricular dilatation, and hypertrophy were potential predictors of this complication.</description><identifier>ISSN: 1099-5129</identifier><identifier>EISSN: 1532-2092</identifier><identifier>DOI: 10.1093/europace/eup350</identifier><identifier>PMID: 19933517</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Antiarrhythmic agents ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - surgery ; Catheter Ablation - utilization ; Comorbidity ; Female ; Germany - epidemiology ; Humans ; Incidence ; Intracranial Embolism - epidemiology ; Magnetic Resonance Imaging - statistics & numerical data ; Male ; Middle Aged ; Pulmonary Veins - surgery ; Risk Assessment - methods ; Risk Factors</subject><ispartof>Europace (London, England), 2010-01, Vol.12 (1), p.52-57</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org. 2010</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-41f5b783b1f03b231772efa47dfb0e30975620f00c72cc16558bd728d0af34933</citedby><cites>FETCH-LOGICAL-c471t-41f5b783b1f03b231772efa47dfb0e30975620f00c72cc16558bd728d0af34933</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,1599,27905,27906</link.rule.ids><linktorsrc>$$Uhttps://dx.doi.org/10.1093/europace/eup350$$EView_record_in_Oxford_University_Press$$FView_record_in_$$GOxford_University_Press</linktorsrc><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19933517$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schrickel, Jan Wilko</creatorcontrib><creatorcontrib>Lickfett, Lars</creatorcontrib><creatorcontrib>Lewalter, Thorsten</creatorcontrib><creatorcontrib>Mittman-Braun, Erica</creatorcontrib><creatorcontrib>Selbach, Stephanie</creatorcontrib><creatorcontrib>Strach, Katharina</creatorcontrib><creatorcontrib>Nähle, Claas P.</creatorcontrib><creatorcontrib>Schwab, Jörg Otto</creatorcontrib><creatorcontrib>Linhart, Markus</creatorcontrib><creatorcontrib>Andrié, Rene</creatorcontrib><creatorcontrib>Nickenig, Georg</creatorcontrib><creatorcontrib>Sommer, Torsten</creatorcontrib><title>Incidence and predictors of silent cerebral embolism during pulmonary vein catheter ablation for atrial fibrillation</title><title>Europace (London, England)</title><addtitle>Europace</addtitle><description>Aims
Left atrial catheter ablation of the pulmonary veins (PV) has evolved as an important therapeutic option for the treatment of atrial fibrillation (AF). We aimed to investigate the incidence and predictors of silent cerebral embolism associated with PV catheter ablation, detected by diffusion-weighted magnetic resonance imaging (DW-MRI).
Methods and results
We performed a prospective analysis of 53 consecutive patients with persistent or paroxysmal AF that underwent PV ablation and post-procedural cerebral MRI 1 day after lasso catheter-guided ostial PV ablation. Patients were analysed for possible demographical, medical, echocardiographical, and procedural predictors of embolic events. A mean of 3.5 ± 0.5 PVs were ablated per patient. In six patients, DW-MRI depicted new clinically silent microembolism after PV ablation (11%). The number of ineffective medical antiarrhythmic agents prior to ablation procedure was significantly higher in the embolism group (3.3 ± 0.5 vs. 2.2 ± 1.4, P = 0.014). Coronary heart disease (CAD) was more frequent in patients with cerebral embolisms (33 vs. 2%, P = 0.031); left ventricular volume (130 ± 12 vs. 103 ± 26 mL, P = 0.002), and septal wall thickness (13.0 ± 1.4 vs. 7.9 ± 4.8 mm, P = 0.025) were significantly increased.
Conclusion
This study shows a high incidence of silent micro-embolic events after PV ablation. CAD, left ventricular dilatation, and hypertrophy were potential predictors of this complication.</description><subject>Antiarrhythmic agents</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - surgery</subject><subject>Catheter Ablation - utilization</subject><subject>Comorbidity</subject><subject>Female</subject><subject>Germany - epidemiology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intracranial Embolism - epidemiology</subject><subject>Magnetic Resonance Imaging - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pulmonary Veins - surgery</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><issn>1099-5129</issn><issn>1532-2092</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1rFjEQxoMotlbPvUluFmHtJNm82RxLqVooeNHzkmQnbWQ3WZOs4H_flH3FWz3NB795mJmHkHMGnxhocYlbTqtx2JJVSHhBTpkUvOOg-cuWg9adZFyfkDel_AQAxbV8TU6Y1kJIpk5JvY0uTBgdUhMnumacgqspF5o8LWHGWKnDjDabmeJi0xzKQqcth3hP121eUjT5D_2NIVJn6gNWzNTY2dSQIvWpFTWHNuuDzWHe-2_JK2_mgu-O8Yz8-Hzz_fprd_fty-311V3nesVq1zMvrRqEZR6E5YIpxdGbXk3eAgrQSh44eACnuHPsIOVgJ8WHCYwXfbvwjHzYddecfm1Y6riE4rBtETFtZVSiZ7pXB2jkxbMk6_VhGFSvZUMvd9TlVEpGP645LO0JI4PxyZTxrynjbkqbeH8U3-yC0z_-6EIDPu5A2tb_qj0CdSKbZg</recordid><startdate>20100101</startdate><enddate>20100101</enddate><creator>Schrickel, Jan Wilko</creator><creator>Lickfett, Lars</creator><creator>Lewalter, Thorsten</creator><creator>Mittman-Braun, Erica</creator><creator>Selbach, Stephanie</creator><creator>Strach, Katharina</creator><creator>Nähle, Claas P.</creator><creator>Schwab, Jörg Otto</creator><creator>Linhart, Markus</creator><creator>Andrié, Rene</creator><creator>Nickenig, Georg</creator><creator>Sommer, Torsten</creator><general>Oxford University Press</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>7TK</scope><scope>7X8</scope></search><sort><creationdate>20100101</creationdate><title>Incidence and predictors of silent cerebral embolism during pulmonary vein catheter ablation for atrial fibrillation</title><author>Schrickel, Jan Wilko ; Lickfett, Lars ; Lewalter, Thorsten ; Mittman-Braun, Erica ; Selbach, Stephanie ; Strach, Katharina ; Nähle, Claas P. ; Schwab, Jörg Otto ; Linhart, Markus ; Andrié, Rene ; Nickenig, Georg ; Sommer, Torsten</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-41f5b783b1f03b231772efa47dfb0e30975620f00c72cc16558bd728d0af34933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Antiarrhythmic agents</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - surgery</topic><topic>Catheter Ablation - utilization</topic><topic>Comorbidity</topic><topic>Female</topic><topic>Germany - epidemiology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Intracranial Embolism - epidemiology</topic><topic>Magnetic Resonance Imaging - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pulmonary Veins - surgery</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schrickel, Jan Wilko</creatorcontrib><creatorcontrib>Lickfett, Lars</creatorcontrib><creatorcontrib>Lewalter, Thorsten</creatorcontrib><creatorcontrib>Mittman-Braun, Erica</creatorcontrib><creatorcontrib>Selbach, Stephanie</creatorcontrib><creatorcontrib>Strach, Katharina</creatorcontrib><creatorcontrib>Nähle, Claas P.</creatorcontrib><creatorcontrib>Schwab, Jörg Otto</creatorcontrib><creatorcontrib>Linhart, Markus</creatorcontrib><creatorcontrib>Andrié, Rene</creatorcontrib><creatorcontrib>Nickenig, Georg</creatorcontrib><creatorcontrib>Sommer, Torsten</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Europace (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext_linktorsrc</fulltext></delivery><addata><au>Schrickel, Jan Wilko</au><au>Lickfett, Lars</au><au>Lewalter, Thorsten</au><au>Mittman-Braun, Erica</au><au>Selbach, Stephanie</au><au>Strach, Katharina</au><au>Nähle, Claas P.</au><au>Schwab, Jörg Otto</au><au>Linhart, Markus</au><au>Andrié, Rene</au><au>Nickenig, Georg</au><au>Sommer, Torsten</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence and predictors of silent cerebral embolism during pulmonary vein catheter ablation for atrial fibrillation</atitle><jtitle>Europace (London, England)</jtitle><addtitle>Europace</addtitle><date>2010-01-01</date><risdate>2010</risdate><volume>12</volume><issue>1</issue><spage>52</spage><epage>57</epage><pages>52-57</pages><issn>1099-5129</issn><eissn>1532-2092</eissn><abstract>Aims
Left atrial catheter ablation of the pulmonary veins (PV) has evolved as an important therapeutic option for the treatment of atrial fibrillation (AF). We aimed to investigate the incidence and predictors of silent cerebral embolism associated with PV catheter ablation, detected by diffusion-weighted magnetic resonance imaging (DW-MRI).
Methods and results
We performed a prospective analysis of 53 consecutive patients with persistent or paroxysmal AF that underwent PV ablation and post-procedural cerebral MRI 1 day after lasso catheter-guided ostial PV ablation. Patients were analysed for possible demographical, medical, echocardiographical, and procedural predictors of embolic events. A mean of 3.5 ± 0.5 PVs were ablated per patient. In six patients, DW-MRI depicted new clinically silent microembolism after PV ablation (11%). The number of ineffective medical antiarrhythmic agents prior to ablation procedure was significantly higher in the embolism group (3.3 ± 0.5 vs. 2.2 ± 1.4, P = 0.014). Coronary heart disease (CAD) was more frequent in patients with cerebral embolisms (33 vs. 2%, P = 0.031); left ventricular volume (130 ± 12 vs. 103 ± 26 mL, P = 0.002), and septal wall thickness (13.0 ± 1.4 vs. 7.9 ± 4.8 mm, P = 0.025) were significantly increased.
Conclusion
This study shows a high incidence of silent micro-embolic events after PV ablation. CAD, left ventricular dilatation, and hypertrophy were potential predictors of this complication.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>19933517</pmid><doi>10.1093/europace/eup350</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1099-5129 |
| ispartof | Europace (London, England), 2010-01, Vol.12 (1), p.52-57 |
| issn | 1099-5129 1532-2092 |
| language | eng |
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| source | Oxford Journals Open Access Collection |
| subjects | Antiarrhythmic agents Atrial Fibrillation - epidemiology Atrial Fibrillation - surgery Catheter Ablation - utilization Comorbidity Female Germany - epidemiology Humans Incidence Intracranial Embolism - epidemiology Magnetic Resonance Imaging - statistics & numerical data Male Middle Aged Pulmonary Veins - surgery Risk Assessment - methods Risk Factors |
| title | Incidence and predictors of silent cerebral embolism during pulmonary vein catheter ablation for atrial fibrillation |
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