Late-Phase Thromboembolism After Catheter Ablation for Paroxysmal Atrial Fibrillation

Background:The aim of this study was to investigate the incidence and predictors (which have not previously been fully elucidated) of late-phase thromboembolism (TE) after catheter ablation (CA) for paroxysmal atrial fibrillation (AF).Methods and Results:We studied 1,156 consecutive patients (61±10...

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Published in:Circulation Journal 2014/09/25, Vol.78(10), pp.2394-2401
Main Authors: Takigawa, Masateru, Takahashi, Atsushi, Kuwahara, Taishi, Takahashi, Yoshihide, Okubo, Kenji, Nakashima, Emiko, Watari, Yuji, Nakajima, Jun, Takagi, Katsumasa, Yamao, Kazuya, Fujino, Tadashi, Sugiyama, Tomoyo, Kimura, Shigeki, Hikita, Hiroyuki, Irioka, Takashi, Hirao, Kenzo, Isobe, Mitsuaki
Format: Article
Language:English
Subjects:
Aged
Atrial fibrillation
Atrial Fibrillation - diagnostic imaging
Atrial Fibrillation - mortality
Atrial Fibrillation - physiopathology
Atrial Fibrillation - surgery
Catheter ablation
Catheter Ablation - adverse effects
Disease-Free Survival
Echocardiography, Transesophageal
Female
Humans
Male
Middle Aged
Postoperative Complications - diagnostic imaging
Postoperative Complications - mortality
Postoperative Complications - physiopathology
Risk Factors
Stroke
Stroke Volume
Survival Rate
Thromboembolism
Thromboembolism - diagnostic imaging
Thromboembolism - etiology
Thromboembolism - mortality
Thromboembolism - physiopathology
Time Factors
TOAST
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Summary:Background:The aim of this study was to investigate the incidence and predictors (which have not previously been fully elucidated) of late-phase thromboembolism (TE) after catheter ablation (CA) for paroxysmal atrial fibrillation (AF).Methods and Results:We studied 1,156 consecutive patients (61±10 years; 891 men; CHADS2score, 0.8±1.0) after CA for symptomatic paroxysmal AF and examined the details of late-phase TE. During a follow-up of 49.5±21.9 months (median, 47 months; range, 6–113 months) after CA, 9 patients (0.78%) developed late-phase TE, all of which were ischemic stroke. Of these, 5 patients with AF recurrence experienced cardioembolism; the AF was asymptomatic at recurrence. The remaining 4 without AF recurrence experienced cardioembolism (n=1), small-vessel occlusion (n=1), large-artery atherosclerosis (n=1), and stroke of other determined etiology (n=1). On Kaplan-Meier analysis patients with structural heart disease (P=0.003), AF recurrence after the final CA (P=0.01), prior stroke (P=0.002), CHADS2score ≥2 (P=0.0002), left ventricular ejection fraction
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-14-0525