Exchanging Catheters Over a Single Transseptal Sheath During Left Atrial Ablation is Associated with a Higher Risk for Silent Cerebral Events |
| |
Authors: | Thomas Deneke Karin Nentwich Rainer Schmitt Georgios Christhopoulos Joachim Krug Luigi Di Biase Andrea Natale Atilla Szollosi Andreas Mugge Patrick Muller Johannes W Dietrich Dong-In Shin Sebastian Kerber Anja Schade |
| |
Affiliation: | 1.Heart Center Bad Neustadt, Clinic for invasive Electrophysiology, Bad Neustadt, GER;2.Ruhr-University Bochum, Bochum, GER;3.Department of Radiology, Bad Neustadt, GER;4.Texas Cardiac Arrhythmia Institute at St. David`s Medical Center, Austin, USA;5.Department of Biomedical Engineering, University of Texas, Austin, USA;6.Department of Cardiology, University of Foggia, Foggia, Italy |
| |
Abstract: | BackgroundSilent cerebral events (SCE) have been identified on magnetic resonance imaging (MRI) in asymptomatic patients after atrial fibrillation (AF) ablation. Procedural determinants influencing the risk for SCE still remain unclear.ObjectiveComparing the risk for SCE depending on exchanges of catheters (ExCath) over a single transseptal sheath.Methods88 Patients undergoing pulmonary vein isolation (PVI) only ablation using either single-tip or balloon-based technique underwent pre- and post-ablation cerebral MRI. Ablations were either performed with double transseptal access and without exchanging catheters over the transseptal sheaths (group 1: no ExCath) or after a single transseptal access and exchanges of therapeutic and diagnostic catheters (group 2: ExCath). Differences in regard to SCE rates were analyzed. Multivariate analysis was performed to identify factors related to the risk for SCE.ResultsIncluded patients underwent PVI using single tip irrigated radiofrequency in 41, endoscopic laser balloon in 27 and cryoballoon in 20 cases. Overall SCE were identified in 23 (26%) patients. In group 1 (no ExCath; N=46) 6 patients (13%) and in group 2 (N=42) 17 patients (40%) had documented SCE (p=0.007). The applied ablation technology did not affect SCE rate. In multivariate analysis age (OR 1.1, p=0.03) and catheter exchanges over a single transseptal sheath (OR 12.1, p=0.007) were the only independent predictors of a higher risk for SCE.ConclusionsExchanging catheters over a single transseptal access to perform left atrial ablation is associated with a significantly higher incidence of SCE compared to an ablation technique using different transseptal accesses for therapeutic and diagnostic catheters. |
| |
Keywords: | Silent cerebral lesions atrial fibrillation ablation magnetic resonance imaging |
本文献已被 ScienceDirect 等数据库收录! |
|