AIMS: Catheter ablation is a potentially curative treatment for atrial fibrillation (AF). However, complications such as ischaemic stroke are more frequent and more severe compared with ablation procedures for other arrhythmias. Irrigated-tip catheters have been reported to reduce the risk of stroke. The present study aimed to evaluate predictors of asymptomatic cerebral infarction (CI) after AF ablation using an irrigated-tip catheter. METHODS AND RESULTS: A total of 70 consecutive AF patients who underwent catheter ablation were subjected to brain magnetic resonance imaging (MRI) 1 day after the procedure. In 10 (14.3%) of 70 patients, MRI revealed acute CI, but neither symptoms nor abnormal neurological findings were present in these patients. In univariate analysis, a history of persistent AF, left atrial dimension, presence of spontaneous echo contrast (SEC), procedure duration prior to heparin injection, and electrical cardioversion during the procedure differed significantly between the two groups, those with and without CI (P = 0.02, 0.05, 0.01, 0.01, and 0.05, respectively). Multivariate logistic regression analysis identified SEC [odds ratio (OR), 9.39; 1.60-55.2; P = 0.01] and procedure duration prior to heparin injection (OR, 1.19; 1.04-1.36; P = 0.01) as predictive of acute asymptomatic CI after AF ablation. CONCLUSION: The presence of SEC and procedure duration prior to heparin injection are determinants of asymptomatic CI during AF ablation despite the use of an irrigated-tip catheter.
AIMS: Catheter ablation is a potentially curative treatment for atrial fibrillation (AF). However, complications such as ischaemic stroke are more frequent and more severe compared with ablation procedures for other arrhythmias. Irrigated-tip catheters have been reported to reduce the risk of stroke. The present study aimed to evaluate predictors of asymptomatic cerebral infarction (CI) after AF ablation using an irrigated-tip catheter. METHODS AND RESULTS: A total of 70 consecutive AFpatients who underwent catheter ablation were subjected to brain magnetic resonance imaging (MRI) 1 day after the procedure. In 10 (14.3%) of 70 patients, MRI revealed acute CI, but neither symptoms nor abnormal neurological findings were present in these patients. In univariate analysis, a history of persistent AF, left atrial dimension, presence of spontaneous echo contrast (SEC), procedure duration prior to heparin injection, and electrical cardioversion during the procedure differed significantly between the two groups, those with and without CI (P = 0.02, 0.05, 0.01, 0.01, and 0.05, respectively). Multivariate logistic regression analysis identified SEC [odds ratio (OR), 9.39; 1.60-55.2; P = 0.01] and procedure duration prior to heparin injection (OR, 1.19; 1.04-1.36; P = 0.01) as predictive of acute asymptomatic CI after AF ablation. CONCLUSION: The presence of SEC and procedure duration prior to heparin injection are determinants of asymptomatic CI during AF ablation despite the use of an irrigated-tip catheter.
Authors: Antonio Dello Russo; Gaetano Fassini; Michela Casella; Antonio Di Monaco; Stefania Riva; Valentina Romano; Massimo Moltrasio; Fabrizio Tundo; Giuseppe De Martino; Benedetta Majocchi; Vittoria Marino; Eleonora Russo; Francesca Pizzamiglio; Giuseppe Del Giorno; Gemma Pelargonio; Luigi Di Biase; Andrea Natale; Claudio Tondo Journal: J Interv Card Electrophysiol Date: 2015-06-23 Impact factor: 1.900