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
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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. / Schmidt, Boris; Gunawardene, Melanie; Krieg, Detlef; Bordignon, Stefano; Fürnkranz, Alexander; Kulikoglu, Mehmet; Herrmann, Wilfried; Chun, K R Julian.
In: J CARDIOVASC ELECTR, Vol. 24, No. 8, 08.2013, p. 869-874.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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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 -