Abstract 14883: Post-Ablation Silent Cerebral Lesions - Long-term Follow-Up Using Magnetic Resonance Imaging
Background: Catheter ablation of atrial fibrillation (AF) is complicated by cerebral emboli resulting in acute ischemia. Recently, silent cerebral lesions (SCL) have been identified with Diffusion-Weighted Magnet Resonance Imaging (MRI).
Objective: The clinical course and longer term characteristics of these lesions are not known and was investigated in this study.
Methods: Out of 86 patients 33 (38%) had new SCL documented on MRI after catheter ablation for AF.14 of these underwent repeat MRI at different time-intervals (2 weeks to 1 year) during follow-up and clinical symptoms as well as size and number of residual lesions were documented.
Results: In post-ablation cerebral MRI, 50 new SCLs were identified (3.6 lesions/patient). No patient presented any neurological symptoms. Distribution of the lesions was predominantly in the left hemisphere (60%) and the cerebellum (26%). 52% of the lesions were small (≤3mm maximum diameter), 42% were medium (4 to 10mm) and 3 lesions (6%) had a maximum diameter >10mm. Follow-up MRI after a median of 3 months revealed 3 residual lesions in 3 patients corresponding to the large acute post-ablation SCLs (>10mm). The remaining 47/50 (94%) of the small or medium-sized lesions were not detectable at follow-up evaluation. No hemorrhagic component or additional lesions were detected.
Conclusions: Most silent embolic MRI-detected lesions observed acutely after AF ablation procedures were ≤10mm in diameter. 94% of all lesions healed without scarring at follow-up
- © 2011 by American Heart Association, Inc.