Transcranial measurement of cerebral microembolic signals during endocardial pulmonary vein isolation: Comparison of three different ablation techniques

Journal of Cardiovascular Electrophysiology

Volumn 20, Issue 10, 2009, Pages 1102-1107

  Sauren, Loes D ^a   Van Belle, Yves ^c   De Roy, Luc ^b   Pison, Laurent ^b   La Meir, Mark ^a   Van Der Veen, Frederick H ^a   Crijns, Harry J ^b   Jordaens, Luc ^c   Mess, Werner H ^a   Maessen, Jos G ^a  

^a MAASTRICHT UNIVERSITY MEDICAL CENTER   (Netherlands)

^b Department of Cardiology ^*  (Belgium)

^c ERASMUS MEDICAL CENTER   (Netherlands)

Author keywords

Ablation; Atrial fibrillation; Cryoablation; Pulmonary vein isolation; Stroke; Transcranial Doppler

Indexed keywords

ADULT; ARTICLE; BRAIN EMBOLISM; CEREBRAL MICROEMBOLISM; CLINICAL ARTICLE; CONTROLLED STUDY; DOPPLER ECHOGRAPHY; FEMALE; HEART ATRIUM FIBRILLATION; HEART SURGERY; HUMAN; MALE; MEASUREMENT; MICROEMBOLISM; MIDDLE CEREBRAL ARTERY; PERCUTANEOUS ENDOCARDIAL ABLATION; PRIORITY JOURNAL; PULMONARY VEIN ISOLATION; RADIOFREQUENCY ABLATION; RISK FACTOR; VASCULAR SURGERY;

ATRIAL FIBRILLATION; CATHETER ABLATION; CRYOSURGERY; ECHOENCEPHALOGRAPHY; FEMALE; HEART CONDUCTION SYSTEM; HUMANS; IRRIGATION; MALE; MIDDLE AGED; PULMONARY VEINS; TREATMENT OUTCOME; ULTRASONOGRAPHY, DOPPLER, TRANSCRANIAL;

EID: 70350518801     PISSN: 10453873     EISSN: 15408167     Source Type: Journal    
DOI: 10.1111/j.1540-8167.2009.01509.x     Document Type: Article

References (28)

1. Wolf PA, Abbott RD, Kannel WB : Atrial fibrillation as an independent risk factor for stroke: The Framingham study. Stroke 1991 22 : 983 988.
2. Cappato R, Calkins H, Chen SA, Davies W, Iesaka Y, Kalman J, Kim YH, Klein G, Packer D, Skanes A : Worldwide survey on the methods, efficacy, and safety of catheter ablation for human atrial fibrillation. Circulation 2005 111 : 1100 1105. (Pubitemid 40365469)
3. Haissaguerre M, Jais P, Shah DC, Takahashi A, Hocini M, Quiniou G, Garrigue S, Le Mouroux A, Le Metayer P, Clementy J : Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998 339 : 659 666.
4. Kilicaslan F, Verma A, Saad E, Rossillo A, Davis DA, Prasad SK, Wazni O, Marrouche NF, Raber LN, Cummings JE, Beheiry S, Hao S, Burkhardt JD, Saliba W, Schweikert RA, Martin DO, Natale A : Trans-cranial Doppler detection of microembolic signals during pulmonary vein antrum isolation: Implications for titration of radiofrequency energy. J Cardiovasc Electrophysiol 2006 17 : 495 501.
5. Lickfett L, Hackenbroch M, Lewalter T, Selbach S, Schwab JO, Yang A, Balta O, Schrickel J, Bitzen A, Luderitz B, Sommer T : Cerebral diffusion-weighted magnetic resonance imaging: A tool to monitor the thrombogenicity of left atrial catheter ablation. J Cardiovasc Electrophysiol 2006 17 : 1 7.
6. Marrouche NF, Martin DO, Wazni O, Gillinov AM, Klein A, Bhargava M, Saad E, Bash D, Yamada H, Jaber W, Schweikert R, Tchou P, Abdul-Karim A, Saliba W, Natale A : Phased-array intracardiac echocardiography monitoring during pulmonary vein isolation in patients with atrial fibrillation: Impact on outcome and complications. Circulation 2003 107 : 2710 2716.
7. Muth CM, Shank ES : Gas embolism. N Engl J Med 2000 342 : 476 482.
8. Pugsley W, Klinger L, Paschalis C, Treasure T, Harrison M, Newman S : The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning. Stroke 1994 25 : 1393 1399.
9. Clark RE, Brillman J, Davis DA, Lovell MR, Price TR, Magovern GJ : Microemboli during coronary artery bypass grafting. Genesis and effect on outcome. J Thorac Cardiovasc Surg 1995 109 : 249 257 discussion 57-58.
10. Van Belle Y, Janse P, Rivero-Ayerza MJ, Thornton AS, Jessurun ER, Theuns D, Jordaens L : Pulmonary vein isolation using an occluding cryoballoon for circumferential ablation: Feasibility, complications, and short-term outcome. Eur Heart J 2007 28 : 2231 2237.
11. Van Belle Y, Janse P, Theuns D, Szili-Torok T, Jordaens L : One year follow-up after cryoballoon isolation of the pulmonary veins in patients with paroxysmal atrial fibrillation. Europace 2008 10 : 1271 1276.
12. Ringelstein EB, Droste DW, Babikian VL, Evans DH, Grosset DG, Kaps M, Markus HS, Russell D, Siebler M : Consensus on microembolus detection by TCD. International Consensus Group on Microembolus Detection. Stroke 1998 29 : 725 729.
13. Bruce GK, Bunch TJ, Milton MA, Sarabanda A, Johnson SB, Packer DL : Discrepancies between catheter tip and tissue temperature in cooled-tip ablation: Relevance to guiding left atrial ablation. Circulation 2005 16 112 : 954 960.
14. Wood MA, Shaffer KM, Ellenbogen AL, Ownby ED : Microbubbles during radiofrequency catheter ablation: Composition and formation. Heart Rhythm 2005 2 : 397 403.
15. Gottesman RF, Wityk RJ : Brain injury from cardiac bypass procedures. Semin Neurol 2006 26 : 432 439.
16. Sylivris S, Levi C, Matalanis G, Rosalion A, Buxton BF, Mitchell A, Fitt G, Harberts DB, Saling MM, Tonkin AM : Pattern and significance of cerebral microemboli during coronary artery bypass grafting. Ann Thorac Surg 1998 66 : 1674 1678.
17. Khairy P, Chauvet P, Lehmann J, Lambert J, Macle L, Tanguay JF, Sirois MG, Santoianni D, Dubuc M : Lower incidence of thrombus formation with cryoenergy versus radiofrequency catheter ablation. Circulation 2003 107 : 2045 2050.
18. Lustgarten DL, Keane D, Ruskin J : Cryothermal ablation: Mechanism of tissue injury and current experience in the treatment of tachyarrhythmias. Prog Cardiovasc Dis 1999 41 : 481 498.
19. van Oeveren W, Crijns HJ, Korteling BJ, Wegereef EW, Haan J, Tigchelaar I, Hoekstra A : Blood damage, platelet and clotting activation during application of radiofrequency or cryoablation catheters: A comparative in vitro study. J Med Eng Technol 1999 23 : 20 25.
20. Zhou L, Keane D, Reed G, Ruskin J : Thromboembolic complications of cardiac radiofrequency catheter ablation: A review of the reported incidence, pathogenesis and current research directions. J Cardiovasc Electrophysiol 1999 10 : 611 620.
21. Lee DS, Dorian P, Downar E, Burns M, Yeo EL, Gold WL, Paquette M, Lau W, Newman DM : Thrombogenicity of radiofrequency ablation procedures: What factors influence thrombin generation? Europace 2001 3 : 195 200.
22. Yokoyama K, Nakagawa H, Wittkampf FH, Pitha JV, Lazzara R, Jackman WM : Comparison of electrode cooling between internal and open irrigation in radiofrequency ablation lesion depth and incidence of thrombus and steam pop. Circulation 2006 113 : 11 19.
23. Pinchuk LS, Kravtsov AG, Zotov SV : Thermally stimulated depolarization of human blood. Technical Physics 2001 46 : 620 622.
24. Padanilam BJ : Cerebral microembolism during AF ablation: An innocent bystander or an accessory to brain injury? J Cardiovasc Electrophysiol 2006 17 : 502 503.
25. Wazni OM, Rossillo A, Marrouche NF, Saad EB, Martin DO, Bhargava M, Bash D, Beheiry S, Wexman M, Potenza D, Pisano E, Fanelli R, Bonso A, Themistoclakis S, Erciyes D, Saliba WI, Schweikert RA, Brachmann J, Raviele A, Natale A : Embolic events and char formation during pulmonary vein isolation in patients with atrial fibrillation: Impact of different anticoagulation regimens and importance of intracardiac echo imaging. J Cardiovasc Electrophysiol 2005 16 : 576 581.
26. Dittrich R, Ritter MA, Kaps M, Siebler M, Lees K, Larrue V, Nabavi DG, Ringelstein EB, Markus HS, Droste DW : The use of embolic signal detection in multicenter trials to evaluate antiplatelet efficacy: Signal analysis and quality control mechanisms in the CARESS (Clopidogrel and Aspirin for Reduction of Emboli in Symptomatic carotid Stenosis) trial. Stroke 2006 37 : 1065 1069.
27. Markus HS, Ackerstaff R, Babikian V, Bladin C, Droste D, Grosset D, Levi C, Russell D, Siebler M, Tegeler C : Intercenter agreement in reading Doppler embolic signals. A multicenter international study. Stroke 1997 28 : 1307 1310.
28. Lund C, Sundet K, Tennoe B, Hol PK, Rein KA, Fosse E, Russell D : Cerebral ischemic injury and cognitive impairment after off-pump and on-pump coronary artery bypass grafting surgery. Ann Thorac Surg 2005 80 : 2126 2131. (Pubitemid 41718040)