Atrial Fibrillation Ablation and Stroke

Philip Aagaard; David Briceno; Zoltan Csanadi; Sanghamitra Mohanty; Carola Gianni; Chintan Trivedi; Edina Nagy-Baló; Stephan Danik; Conor Barrett; Francesco Santoro; J David Burkhardt; Javier Sanchez; Andrea Natale; Luigi Di Biase

doi:10.1016/j.ccl.2015.12.012

Atrial Fibrillation Ablation and Stroke

Cardiol Clin. 2016 May;34(2):307-16. doi: 10.1016/j.ccl.2015.12.012.

Affiliations

¹ Department of Medicine, Albert Einstein College of Medicine, Montefiore Hospital, Bronx, NY, USA.
² Department of Cardiology, University of Debrecen, 22 Móricz Zs, Debrecen H4032, Hungary.
³ Department of Cardiology, Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, TX, USA.
⁴ The Al-Sabah Arrhythmia Institute at Mount Sinai St. Luke, New York, NY, USA.
⁵ Department of Cardiology, University of Foggia, Foggia, Italy.
⁶ Department of Cardiology, Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, TX, USA; Division of Cardiology, Stanford University, Stanford, CA, USA; CaseWestern Reserve University, Cleveland, OH, USA; EP Services, California Pacific Medical Center, San Francisco, CA, USA; Interventional Electrophysiology, Scripps Clinic, San Diego, CA, USA; Dell Medical School, University of Texas, Austin, TX, USA. Electronic address: dr.natale@gmail.com.
⁷ Department of Cardiology, Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, TX, USA; Department of Cardiology, University of Foggia, Foggia, Italy; Department of Biomedical Engineering, University of Texas, Austin, TX, USA. Electronic address: dibbia@gmail.com.

PMID: 27150179
DOI: 10.1016/j.ccl.2015.12.012

Abstract

Catheter ablation has become a widely available and accepted treatment to restore sinus rhythm in atrial fibrillation patients who fail antiarrhythmic drug therapy. Although generally safe, the procedure carries a non-negligible risk of complications, including periprocedural cerebral insults. Uninterrupted anticoagulation, maintenance of an adequate ACT during the procedure, and measures to avoid and detect thrombus build-up on sheaths and atheters during the procedure, appears useful to reduce the risk of embolic events. This is a review of the incidence, mechanisms, impact, and methods to reduce catheter ablation related cerebral insults.

Keywords: Anticoagulation; Atrial fibrillation; Silent cerebral ischemia; Stroke.

Publication types

Review

MeSH terms

Atrial Fibrillation / complications
Atrial Fibrillation / surgery*
Catheter Ablation / methods*
Global Health
Heart Conduction System / physiopathology
Heart Conduction System / surgery*
Humans
Incidence
Risk Factors
Stroke / epidemiology*
Stroke / etiology