A prospective randomized single-center study on the risk of asymptomatic cerebral lesions comparing irrigated radiofrequency current ablation with the cryoballoon and the laser balloon

TY - JOUR

T1 - A prospective randomized single-center study on the risk of asymptomatic cerebral lesions comparing irrigated radiofrequency current ablation with the cryoballoon and the laser balloon

AU - Schmidt, Boris

AU - Gunawardene, Melanie

AU - Krieg, Detlef

AU - Bordignon, Stefano

AU - Fürnkranz, Alexander

AU - Kulikoglu, Mehmet

AU - Herrmann, Wilfried

AU - Chun, K R Julian

N1 - © 2013 Wiley Periodicals, Inc.

PY - 2013/8

Y1 - 2013/8

N2 - BACKGROUND: Asymptomatic cerebral lesions (ACL) may occur during atrial fibrillation (AF) ablation. We sought to compare the ACL incidence between 3 contemporary technologies: (1) irrigated radiofrequency current (RFC), (2) the single big cryoballoon (CB), and (3) the endoscopic laser-balloon (LB) in a prospective randomized pilot study.METHODS AND RESULTS: Ninety-nine patients were treated in 3 groups. Diffusion weighted MRI was acquired pre- (n = 20) and 24-48 h postablation (n = 99). After ablation, new ACL were detected in 22% of patients without significant differences between groups (RFC 8/33; CB 6/33; LB 8/33; P = 0.8). The presence of hypertension was identified as the only independent predictor of ACL by univariate regression analysis. During LB ablation, more ablation lesions (140 ± 19 vs 119 ± 18; P = 0.007) were applied during longer procedures (166 ± 36 vs 143 ± 32 min; P = 0.05) in patients with ACL. Univariate analysis revealed that a higher number of ablation lesions predicted ACL (P = 0.02).CONCLUSION: In this prospective, randomized, single-center pilot study, ablation technology did not influence the occurrence of ACL during AF ablation.

AB - BACKGROUND: Asymptomatic cerebral lesions (ACL) may occur during atrial fibrillation (AF) ablation. We sought to compare the ACL incidence between 3 contemporary technologies: (1) irrigated radiofrequency current (RFC), (2) the single big cryoballoon (CB), and (3) the endoscopic laser-balloon (LB) in a prospective randomized pilot study.METHODS AND RESULTS: Ninety-nine patients were treated in 3 groups. Diffusion weighted MRI was acquired pre- (n = 20) and 24-48 h postablation (n = 99). After ablation, new ACL were detected in 22% of patients without significant differences between groups (RFC 8/33; CB 6/33; LB 8/33; P = 0.8). The presence of hypertension was identified as the only independent predictor of ACL by univariate regression analysis. During LB ablation, more ablation lesions (140 ± 19 vs 119 ± 18; P = 0.007) were applied during longer procedures (166 ± 36 vs 143 ± 32 min; P = 0.05) in patients with ACL. Univariate analysis revealed that a higher number of ablation lesions predicted ACL (P = 0.02).CONCLUSION: In this prospective, randomized, single-center pilot study, ablation technology did not influence the occurrence of ACL during AF ablation.

KW - Aged

KW - Analysis of Variance

KW - Brain Diseases/diagnosis

KW - Catheter Ablation/adverse effects

KW - Conscious Sedation

KW - Cryosurgery/adverse effects

KW - Echocardiography, Transesophageal

KW - Female

KW - Humans

KW - Laser Therapy/adverse effects

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

KW - Pilot Projects

KW - Prospective Studies

KW - Risk Factors

KW - Therapeutic Irrigation

KW - Treatment Outcome

U2 - 10.1111/jce.12151

DO - 10.1111/jce.12151

M3 - SCORING: Journal article

C2 - 23601001

VL - 24

SP - 869

EP - 874

JO - J CARDIOVASC ELECTR

JF - J CARDIOVASC ELECTR

SN - 1045-3873

IS - 8

ER -