Abstract 14710: Incidence Of Procedure-related Thromboembolism In Patients With Atrial Fibrillation Treated By Irrigated / Non-irrigated Ablation Catheter
Background: Cerebral embolism and stroke are serious procedural complications in patients with atrial fibrillation (AF) underwent catheter ablation. Although open saline irrigated ablation system is expected to reduce the incidence of cerebral embolism, its efficacy in clinical practice remains unknown.
Methods: A total of 231AF patients (paroxysmal AF: 128 and persistent AF: 103) who underwent catheter ablation by using non-irrigated (group NI: 57 patients) or an open saline irrigated (group I: 174 patients) ablation catheter was included. During mapping and ablation, heparin was intravenously administered with a target activated coagulation time of 300-350 seconds. In all patients, pulmonary veins were isolated at their antrum and supplemental ablation in the left atrium to modify the substrate was performed in persistent AF patients. Brain diffusion-weighted magnetic resonance imaging (DWI) was performed 2 day after the ablation procedure in all patients.
Results: There were no procedural complication and the endpoint of catheter ablation was achieved in all patients. Optimal anticoagulant treatment with warfarin was performed in 90.0% (207/231) of patients prior to ablation. No significant differences were observed in clinical variables between group NI and I. In total, thromboembolism was revealed by the DWI in 50 patients (paroxysmal: 16.4% (21/128) and persistent AF: 28.1% (29/103), P=0.046). There was no significant difference in the incidence of embolism between group NI and I (17.5% (10/57) vs. 30.0% (40/174), P=0.50). No symptomatic thromboembolism was observed in this study population.
Conclusion: An open saline irrigated ablation system did not reduce the incidence of the silent thromboembolism related to ablation procedure compared to non-irrigated conventional ablation catheter.
- © 2011 by American Heart Association, Inc.