Abstract 18341: Prospective, Multicenter Study on the Incidence of New Embolic Cerebral Lesions following Pulmonary Vein Isolation Using Laserballoon Ablation
Background: Silent cerebral embolism following catheter ablation for atrial fibrillation (AF) has recently been described and its incidence varies depending on the intraprocedural anticoagulation strategy chosen or the ablation technology used. Its incidence following laserballoon ablation for AF is currently unknown. This multicenter, prospective study reports on the number of new lesions on postprocedural cerebral MRI following pulmonary vein isolation using laser-, cryo- or radiofrequency (RF) ablation.
Methods: Each patient underwent cerebral MRI before catheter ablation for AF. Target ACT during the procedure was ≥ 300 s. Pulmonary vein isolation was performed using laserballoon (group 1), cryoballoon (group 2) or irrigated RF (group 3) ablation. Following the procedure all patients underwent repeat cerebral MRI.
Results: Of a total of 72 patients (age: 63±9 years, 75% paroxysmal AF), 6/44 (13.6%) in group 1, 0/11 (0%) in group 2 and 3/17 (17.6%) in group 3 demonstrated new cerebral lesions on postprocedural MRI. Two patients with lesions in group 1 necessitated RF touch-up ablation, one of whom experienced diplopia with complete remission within days. No other gross abnormal neurological findings were detected in the remaining patients. Follow-up MRIs in those patients with lesions are currently underway.
Conclusions: Laserballoon-based catheter ablation of AF demonstrates a similar safety profile regarding the rate of cerebral lesions than established ablation technologies.
- © 2012 by American Heart Association, Inc.