Abstract 11462: Neurocognitive Function and Silent Cerebral Thromboemboli Following Atrial Fibrillation Catheter Ablation
Introduction: Silent cerebral thromboemboli following pulmonary vein isolation (PVI) catheter ablation for atrial fibrillation (AF) have been reported, but their clinical impact on neurocognitive dysfunction or longer term persistence remains unclear.
Hypothesis: There is no difference in neurocognitive function tested 3-6 months after AF ablation in patients with silent cerebral thromboemboli.
Methods: In a prospective pilot study, patients presenting for PVI were approached for inclusion. Consenting patients underwent a battery of 8 neurocognitive tests (see Table) and diffusion-weighted MRI (dMRI) within 3 days before procedure. A follow up dMRI was done within 3 days post procedure. The neurocognitive battery was repeated at 3-6 months after ablation.
Results: Of 20 patients included, 6 patients (30%) had a new silent cerebral lesion on the follow up dMRI. A third MRI was done in 2 patients and their dMRI was back to normal. Radiofrequency ablation was done in 18 patients (90%) and Cryo ablation for the 2 remaining patients. Patients with silent strokes were less likely to have hypertension and more likely to have had previous aortic valve replacement and current treatment with dofetilide. In patients with silent lesions (n=6), scores of neurocognitive tests done were unchanged at follow up suggesting the lack of neurocognitive dysfunction. The median (IQR) FAS total and adjusted scores improved in patients without a silent lesion (n=14), p=0.008 and p=0.01 respectivley, with a trend toward improvement in patients with a silent lesion, p=0.41 and p=0.5, repectivley. The median (IQR) Boston total score decreased in patients without a silent lesion (54.5(28.75,57.75) to 28.5(23.75,29.25)), p=0.041). All other scores were unchanged.
Conclusions: Silent cerebral lesions are present in up to 30% after ablation but no correlation with neurocognitive dysfunction was found.
Author Disclosures: M. Qintar: None. M. Hammadah: None. P. Hanna: None. M. Panko: None. K. Niebaur: None. R. Naugle: None. M. Chung: None.
- © 2014 by American Heart Association, Inc.