| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | Journal of Interventional Cardiac Electrophysiology | ||||
| Publisher: | SPRINGER | ||||
| Place of Publication: | DORDRECHT | ||||
| Volume: | 43 | ||||
| Number of Issue or Book Chapter: | 3 | ||||
| Page Range: | pp. 217-226 | ||||
| Date: | 2015 | ||||
| Institutions: | Medicine > Lehrstuhl für Innere Medizin II Medicine > Lehrstuhl für Neurologie Medicine > Lehrstuhl für Röntgendiagnostik | ||||
| Identification Number: |
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| Keywords: | PULMONARY VEIN ISOLATION; WHITE-MATTER CHANGES; RADIOFREQUENCY ABLATION; IRRIGATED RADIOFREQUENCY; FIBRILLATION ABLATION; MICROEMBOLISM; LESIONS; SAFETY; CRYOBALLOON; EFFICACY; Catheter ablation; Atrial fibrillation; Silent cerebral microembolism; MRI | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 60185 |
Web of ScienceAbstract
Recently, diffusion-weighted magnetic resonance imaging (DW-MRI) revealed silent cerebral events (SCEs) as an acute complication of pulmonary vein isolation (PVI). We investigated whether SCEs following PVI are associated with neuropsychological deficits observed during patients' follow-up examinations. After PVI, 52 patients were eligible for follow-up. PVI was performed using a variety of ...
Abstract
Recently, diffusion-weighted magnetic resonance imaging (DW-MRI) revealed silent cerebral events (SCEs) as an acute complication of pulmonary vein isolation (PVI). We investigated whether SCEs following PVI are associated with neuropsychological deficits observed during patients' follow-up examinations. After PVI, 52 patients were eligible for follow-up. PVI was performed using a variety of ablation technologies (duty-cycled phased radiofrequency (RF) multipolar ablation with the Pulmonary Vein Ablation CatheterA (R) (PVAC) in 24 patients, cooled-tip RF ablation in 23 patients, and cryoballoon ablation in five patients). Fluid-attenuated inversion recovery (FLAIR)- and DW-MRI studies were performed 1 day before PVI and 1 day and 1 month afterward to detect pre-existing cerebral lesions or post-ablation SCEs. At the same times, eight neuropsychological tests were administered. We evaluated changes in patients' neuropsychological capabilities and compared changes in patients with SCEs to those without SCEs. FLAIR-MRI revealed pre-existing cerebral lesions in 42 patients (81 %), and DW-MRI demonstrated new SCEs in 25 patients (48 %) (17 treated with phased RF (PVAC) (71 %), six treated with irrigated RF (26 %), and two treated with cryoablation (40 %)). Neuropsychological test results showed no significant impairment (in median z scores) 1 day and 1 month after the ablation procedure. There was no difference in neuropsychological capabilities between patients with SCEs and those without SCEs except in one subtest (part of the verbal working memory test). The incidence of pre-existing cerebral lesions and post-ablation SCEs was high. The frequency of SCEs depends on the ablation technology used. Neither PVI nor post-ablation SCEs have any effect on neuropsychological capabilities.
Metadata last modified: 19 Dec 2024 07:27
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