Cerebrovascular Complications Related to Atrial Fibrillation Ablation and Strategies for Periprocedural Stroke Prevention

Zoltan Csanadi; Edina Nagy-Baló; Stephan Danik; Conor Barrett; J David Burkhardt; Javier Sanchez; Pasquale Santangeli; Francesco Santoro; Luigi Di Biase; Andrea Natale

doi:10.1016/j.ccep.2013.10.003

Cerebrovascular Complications Related to Atrial Fibrillation Ablation and Strategies for Periprocedural Stroke Prevention

Card Electrophysiol Clin. 2014 Mar;6(1):111-23. doi: 10.1016/j.ccep.2013.10.003.

Authors

Affiliations

¹ Department of Cardiology, University of Debrecen, 22 Móricz Zs, Debrecen H4032, Hungary. Electronic address: drcsanadi@hotmail.com.
² Department of Cardiology, University of Debrecen, 22 Móricz Zs, Debrecen H4032, Hungary.
³ Al-Sabah Arrhythmia Institute (AI), St. Luke's Hospital, NY, USA.
⁴ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA.
⁵ Clinical Cardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA; Department of Cardiology, University of Foggia, Foggia, Italy.
⁶ Department of Cardiology, University of Foggia, Foggia, Italy.
⁷ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA; Department of Cardiology, University of Foggia, Foggia, Italy; Albert Einstein College of Medicine, Montefiore Hospital, Bronx, NY, USA; Department of Biomedical Engineering, University of Texas, Austin, TX, USA.
⁸ Case Western Reserve University, Cleveland, OH, USA; Interventional Electrophysiology, Scripps Clinic, San Diego, CA, USA; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, USA; Department of Biomedical Engineering, University of Texas, Austin, TX, USA.

PMID: 27063826
DOI: 10.1016/j.ccep.2013.10.003

Abstract

Transcatheter treatment of atrial fibrillation (AF) is a complex intervention performed in patients who are at inherently increased risk of a thromboembolic complication, including stroke. It is therefore not surprising that cerebrovascular accidents have been among the most feared complications since the inception of AF ablation. While improvements have been made to limit the incidence of thromboembolic events during catheter ablation of AF, the optimal strategy to minimize such complications has yet to be determined. It is hoped that larger trials using periprocedural anticoagulation strategies can be undertaken to definitively address these important concerns.

Keywords: Atrial fibrillation; Diffusion-weighted cerebral magnetic resonance imaging; Silent cerebral ischemia; Stroke; Transcranial Doppler.

Publication types

Review