Abstract 14960: Effect of Catheter Ablation on the Clinical Manifestation of Migraine in AF Patients with or without Pre-Existent Migraine -Results from a Prospective Study (CONFIRM)
Background: Whether there is an association between atrial fibrillation (AF), trans-septal puncture during catheter ablation (CA) and migraine is yet to be defined. This study examined the influence of CA on the incidence and severity of migraine in patients with or without pre-ablation migraine-history.
Methods: Twenty patients with history of migraine (study group, 64±8 years, male 77%, 67% non-paroxysmal AF) and 48 without migraine history (control, 61±10 years, male 73%, 76% non-paroxysmal AF) undergoing CA for AF were prospectively enrolled. The migraine status was assessed at baseline and 3-month post-ablation using American Migraine Center questionnaire. Diffusion MRI (dMRI) was performed for all at baseline and 24-hour post-procedure.
Results: At 3-month follow-up, none of the 48 control patients reported new-onset migraine; while among the study population, 9(47%) patients had no migraine and 8(40%) had reduction in frequency and severity of migraine. In the remaining 3 patients, symptoms either worsened (in one) or remained unchanged (in two). Pre-ablation dMRI of the study cohort was negative in all except 3 (15%) patients, in whom small old cortical infarcts were detected. These 3 patients experienced higher frequency and severity of migraine at baseline and the symptom-burden diminished after ablation. Follow-up dMRI did not show any new lesion in this population. In the control group, baseline dMRI demonstrated no abnormality in all but 5 patients in whom mild to moderate cerebral atrophy was detected; no change in dMRI was noticed at follow-up.
Conclusion: Catheter ablation was not associated with new-onset migraine or worsening of the existing migraine status. Rather, it reduced the severity and frequency of the headache in nearly half of patients with pre-existent migraine.
- © 2012 by American Heart Association, Inc.