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- Title
Impact of Ablation Catheter Irrigation Design on Silent Cerebral Embolism After Radiofrequency Catheter Ablation of Atrial Fibrillation: Results from a Pilot Study.
- Authors
SCAGLIONE, MARCO; BLANDINO, ALESSANDRO; RAIMONDO, CRISTINA; CAPONI, DOMENICO; Di DONNA, PAOLO; TOSO, ELISABETTA; EBRILLE, ELISA; CESARANI, FEDERICO; FERRARESE, EVA; GAITA, FIORENZO
- Abstract
Catheter Design and Anticoagulation on Postablation Silent Cerebral Ischemia. Introduction: Silent cerebral lesions (SCL) are a sensitive tool to evaluate thromboembolic risk of catheter ablation. Recent data showed the possibility to reduce thrombus formation when the electrode-tissue interface cooling is optimized by a homogeneous flushing of saline along the entire surface of the distal electrode through a larger number of irrigation holes. The study aim is to compare procedural parameters and safety of pulmonary vein isolation (PVI) performed by using open-irrigated catheters with different irrigation design. Methods and Results: Eighty patients (74% males; age 57 ± 12 years) with paroxysmal AF randomly underwent PVI performed with a new irrigation design catheter (group A, 40 patients) versus a standard irrigated catheter (group B, 40 patients). A cerebral magnetic resonance imaging (MRI) was performed before and after the procedure. Postprocedural brain MRI unveiled SCL in 2 patients in group A and in 3 in group B (5% vs 7.5%, P = 0.500). Intraprocedural ACT was the only independent factor associated with the occurrence of SCL (OR = 0.996; 95% CI 0.994-0.998, P < 0.001). Among procedural parameters, we observed a reduction of irrigation saline volume of 662 mL in group A versus group B (P < 0.001). Conclusion: PVI performed with a new irrigated catheter did not reduce significantly the SCL risk when compared to a standard irrigated catheter. Intraprocedural ACT reduces the SCL risk of 0.4% for each point of ACT increase. For ACT > 320 seconds no SCL occurred. Finally, compared to a standard irrigated catheter, PVI performed with a new irrigation design catheter reduces significantly saline volume infusion. (J Cardiovasc Electrophysiol, Vol. 23, pp. 801-805, August 2012)
- Subjects
PULMONARY veins; CEREBRAL embolism &; thrombosis; STROKE risk factors; ANALYSIS of variance; ATRIAL fibrillation; CONFIDENCE intervals; CATHETER ablation; STATISTICAL correlation; EPIDEMIOLOGY; LONGITUDINAL method; MAGNETIC resonance imaging; MULTIVARIATE analysis; PATIENT safety; PRODUCT design; DATA analysis; RANDOMIZED controlled trials; DATA analysis software; DESCRIPTIVE statistics; PREVENTION; SURGERY; EQUIPMENT &; supplies
- Publication
Journal of Cardiovascular Electrophysiology, 2012, Vol 23, Issue 8, p801
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/j.1540-8167.2012.02298.x