Author + information
- Andreas Bollmann,
- Jedrzej Kosiuk,
- Jelena Kornej,
- Krzysztof Myrda,
- Arash Arya,
- Thomas Gaspar,
- Christopher Piorkowski,
- Philipp Sommer,
- Gerhard Hindricks and
- Gregory Lip
Cerebral thromboembolic complications remain one of the most severe complications of catheter ablation of atrial fibrillation (AF). However, due to different ablation approaches, energy sources and peri-interventional management there is inconsistent data on incidence, characteristics and outcome of such events. Furthermore, potential risk factors helping to guide risk stratification are not well defined.
We analyzed cerebral thromboembolic events within 30 days following single-center radiofrequency catheter ablation of AF in 3.360 consecutive procedures. Stroke was defined as a neurologic deficit lasting more than 24 hours or with cerebral imaging showing new infarction, while transient ischemic attack (TIA) was defined as a deficit lasting less than 24 hours and without documented infarction.
There were 16 peri-interventional cerebral thromboembolic events (0.47 %) within the first 30 days after ablation. Nine cases were confirmed strokes (56 %) and 7 TIAs (44 %) without remaining neurological deficits. Sixty percent of the events occurred within 48 hours after the procedure and the rest within one week. In univariate analysis, peri-interventional thromboembolism was associated with peripheral vascular disease (p=0.006), impaired left ventricular ejection fraction (p=0.04), peri-procedural bridging with heparin (p=0.003) and previous stroke (p=0.018). Multivariable analysis revealed peripheral vascular disease (OR 8.144, CI 1.698-39.050, p=0.009) and previous stroke (OR 7.129, CI 1.497-33.955, p=0.014) as independent predictors for thromboembolic complications.
Cerebral thromboembolic complications following radiofrequency catheter ablation of AF 1) are rare, 2) occur mostly within 48 hours after the procedure, 3) are associated with peripheral vascular disease and previous stroke, and 4) remain without long-term consequences in almost half of the cases.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Arrhythmias: AF/SVT II
Abstract Category: 4. Arrhythmias: AF/SVT
Presentation Number: 1107-50
- 2013 American College of Cardiology Foundation