Purpose: Asymptomatic cerebral lesions detected by diffusion-weighted magnetic resonance imaging (MRI) following atrial fibrillation (AF) ablation were reported in recent years. It was reported that cardioversion during the procedure of AF ablation was one independent risk factor of asymptomatic cerebral lesions. However, in some studies, the similar association between asymptomatic cerebral lesions and intraprocedural cardioversion was not observed. Given the inconsistent results, we did a meta-analysis to explore the influence of intraprocedural cardioversion on the asymptomatic cerebral lesions detected by MRI following AF ablation.
Methods: Studies exploring the association between cardioversion during AF ablation and asymptomatic cerebral lesions following AF ablation were systematically searched in PubMed, Web of Science and the Cochrane Library Databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled. Subgroup and sensitivity analyses were performed to explore the source of heterogeneity.
Results: Nine studies involving 813 participants were included in the present meta-analysis. When we pooled data from nine studies using fixed-effects model, we found cardioversion during the procedure significantly increased the risk of asymptomatic cerebral lesions detected by MRI following AF ablation (pooled OR = 1.793, 95% CI 1.201-2.678, I (2) = 38.8%, P heterogeneity = 0.109).
Conclusions: Cardioversion during AF ablation significantly increased the risk of asymptomatic cerebral lesions on MRI following the procedure. Additional studies are required to further verify the association.