Back to Search
Start Over
Incidence and outcomes of cerebrovascular events complicating catheter ablation for atrial fibrillation.
- Source :
-
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2016 Sep; Vol. 18 (9), pp. 1357-65. Date of Electronic Publication: 2015 Dec 23. - Publication Year :
- 2016
-
Abstract
- Aims: Cerebrovascular complications are relatively uncommon, but severe adverse events are associated with catheter ablation of atrial fibrillation (AF). This study aimed to investigate the incidence, risk factors, and hospital outcomes of cerebrovascular events complicating AF ablation.<br />Methods and Results: Cerebrovascular complications occurring during the procedure or hospitalization after AF ablation were assessed. Cerebrovascular events occurred in 9 of 1946 consecutive procedures (0.46%). Seven patients (0.36% per procedure) were diagnosed with ischaemic stroke and two patients (0.1% per procedure) with intracranial haemorrhage (ICH). Six events (6/9, 66.7%) occurred during the ablation and the remainders within 24 h after the ablation. Multivariable analysis revealed that previous ischaemic stroke [odds ratio (OR) 10.549; 95% confidence interval (CI) 2.551-43.625, P = 0.001] and mechanical valve replacement (OR 3.261; 95% CI 1.337-7.953, P = 0.009) were independent predictors. In a separate model, CHA2DS2-VASc score ≥3 (OR 7.992; 95% CI 2.046-31.215, P = 0.003) and mechanical valve replacement (OR 4.104; 95% CI 1.644-10.245, P = 0.002) were significantly associated with cerebrovascular complications. All patients survived to discharge except the two cases with ICH.<br />Conclusion: Cerebrovascular complications related to catheter ablation of AF are relatively infrequent and typically occur early either during the procedure or within the first 24 h after AF ablation. Previous ischaemic stroke, mechanical valve replacement, and CHA2DS2-VASc score ≥3 are independent predictors of such complications. The majority of these events are ischaemic stroke with a benign clinical outcome, while ICH may correlate with poor prognosis.<br /> (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)
- Subjects :
- Aged
Atrial Fibrillation diagnosis
Atrial Fibrillation epidemiology
Atrial Fibrillation physiopathology
Biopsy
Brain Ischemia epidemiology
Cerebral Angiography methods
Cerebrovascular Disorders diagnostic imaging
Cerebrovascular Disorders therapy
China epidemiology
Female
Heart Valve Prosthesis Implantation adverse effects
Humans
Incidence
Intracranial Hemorrhages epidemiology
Logistic Models
Magnetic Resonance Imaging
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Risk Factors
Stroke epidemiology
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Atrial Fibrillation surgery
Catheter Ablation adverse effects
Cerebrovascular Disorders epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1532-2092
- Volume :
- 18
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 26705560
- Full Text :
- https://doi.org/10.1093/europace/euv356