Incidence of Asymptomatic Cerebral Microthromboembolism After Atrial Fibrillation Ablation Guided by Complex Fractionated Atrial Electrogram

• DOI: 10.1111/j.1540-8167.2011.02259.x
• Publication Date: 2012-02-07T19:33:09Z
• Authors: HITOSHI ICHIKI; NAOYA OKETANI; SANEMASA ISHIDA; YASUHISA IRIKI; HIDEKI OKUI; RYUICHI MAENOSONO; YUICHI NINOMIYA; TAKEHIKO MATSUSHITA; MASAAKI MIYATA; SHUICHI HAMASAKI; CHUWA TEI
• Keywords: Aged, 80 and over; Male; Chi-Square Distribution; Incidence; Coronary Stenosis; Middle Aged; Coronary Angiography; 3. Good health; Diffusion Magnetic Resonance Imaging; Intracranial Embolism; Japan; Asymptomatic Diseases; Atrial Fibrillation; Multivariate Analysis; Catheter Ablation; Odds Ratio; Humans; Female; Intracranial Thrombosis; Electrophysiologic Techniques, Cardiac; Aged

Cerebral Microthromboembolism After CFAE Ablation . Background: The incidence of cerebral thromboembolism after pulmonary vein isolation (PVI) ranges from 2% to 14%. This study investigated the complex fractionated atrial electrogram (CFAE) ablation with or without PVI. Methods: One hundred consecutive fibrillation (AF) patients (50 paroxysmal and 50 persistent, including 10 longstanding) who underwent combined (n = 41, PVI+CFAE group) 59, PVI were studied. Coronary angiography (CAG) was conducted AF in 5 cases which coronary artery stenosis suspected on 3D‐computed tomography. performed before circular catheter during AF. termination AF, additional complete a catheter. All magnetic resonance imaging (MRI) diffusion‐weighted MRI T2‐weighted day ablation. Results: New detected 7.0%, there no significant difference between 2 strategies (7.3% group, 6.8% group). CHADS2 score (1.6 ± 1.0 vs 0.8 0.9, P < 0.05), left volume (LAV; 83.8 27.1 67.8 21.8, ventricular ejection fraction (LVEF, 53.1 9.2 65.1 9.7, 0.01) significantly different when comparing thromboembolism. In multivariate analysis, LVEF (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.84–0.99; 0.05) concomitant CAG (OR 18.82; CI, 1.77–200.00; important predictors new Conclusions: microthromboembolism not greater than previous reports Cautious management is required ablation, especially low LVEF. (J Cardiovasc Electrophysiol, Vol. 23, pp. 567–573, June 2012)