PhD Scientific Days 2017

Oral Presentations: Cardiovascular

Silent cerebral ischaemia after point-by-point radiofrequency pulmonary vein isolation

Előadó neve

Dr. Herczeg, Szilvia

Előadó munkahelye

Heart and Vascular Center of Semmelweis University

Előadó telefonszáma

0036303750220

Előadó e-mail címe

szilvi.herczeg@gmail.com

Az előadás címe

Silent cerebral ischaemia after point-by-point radiofrequency pulmonary vein isolation

Szerző(k) neve és munkahelye

Szilvia Herczeg , Nándor Szegedi , Klaudia Vivien Nagy , Katalin Piros , Zoltán Salló , István Osztheimer , Béla Merkely , Gábor Széplaki , László Gellér
Heart and Vascular Center of Semmelweis University, Budapest

Szekció

Oral Presentations: Cardiovascular

Data of the presenter

Doctoral School: Doctoral School of Basic Medicine
Program: Cardiovascular Disorders: Physiology and Medicine of Ischaemic Circulatory Diseases
Supervisor: László Gellér
Email: szilvi.herczeg@gmail.com

Text of the abstract

Introduction
After pulmonary vein isolation (PVI) therapy for atrial fibrillation (AF) silent cerebral ischaemic lesion (SCI) – detected by MRI – may occur. The prevalence of lesions differ according to the used ablation techniques. Data exist mainly regarding devices with larger surface, such as cryoballon or Multielectrode Pulmonary Vein Ablation Catheter (PVAC). However we know less about the incidence of SCI after point-by-point radiofrequency (RF), focal ablation. Our aim was to describe the incidence and risk factors of SCI occurring after RF PVI.

Methods
27 patients with paroxysmal AF, scheduled for RF PVI in 2015-2016 were involved in our prospective study. Point-by-point RF PVI was performed with uninterrupted oral anticoagulation (in case of coumarin therapy INR: 2-3) and with activated clotting time target above 300 sec. In 72 hours after ablation cerebral MRI was conducted using T2 weighted imaging, FLAIR and DW sequence looking for SCI. If SCI was found, second MRI was scheduled. Besides, complex neurocognitive test was filled out by patients before and after the ablation, and at 3 months visit.

Results
After the successful PVI all 27 patients (14 men, 13 woman, mean age 62 ± 10, median CHA2DS2-VASc-score 2) had no complication, neither symptomatic, nor silent acute ischaemic lesions detected by MRI. However by 74% of patients chronic microvascular ischaemic lesion was found. There was no apparent neurocognitive decline according to the neurocognitive tests.

Conclusions
According to the literature more frequently (range 2-71%) SCI occurs after PVI using “single shot” catheters. After RF point-by-point ablation less SCI events are described (range 3-26%). Nevertheless in our study none of the patients had SCI. Therefore, according to the results in our patient population, we consider RF point-by-point PVI as a safe method among other ablation techniques.

Kind

Szabad

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

1317

Authors (legacy)

Szilvia Herczeg , Nándor Szegedi , Klaudia Vivien Nagy , Katalin Piros , Zoltán Salló , István Osztheimer , Béla Merkely , Gábor Széplaki , László Gellér
Heart and Vascular Center of Semmelweis University, Budapest