Incidence and long-term follow-up of silent cerebral lesions after pulmonary vein isolation using a remote robotic navigation system as compared with manual ablation

Circulation: Arrhythmia and Electrophysiology

Volumn 5, Issue 1, 2012, Pages 15-21

  Rillig, Andreas ^a,b   Meyerfeldt, Udo ^a   Tilz, Roland Richard ^a,b   Talazko, Jochen ^a   Arya, Anita ^a,b   Zvereva, Vlada ^a   Birkemeyer, Ralf ^a   Miljak, Tomislav ^a   Hajredini, Bajram ^a   Wohlmuth, Peter ^c   Fink, Ulrich ^a   Jung, Werner ^a  

^a UNIVERSITY OF FREIBURG   (Germany)

^b DEPARTMENT OF CARDIOLOGY   (Germany)

^c Global Clinical Information   (Germany)

Author keywords

Cerebral MRI; Pulmonary vein isolation; Robotic navigation; Silent cerebral lesion

Indexed keywords

HEPARIN;

ABLATION THERAPY; ADULT; AGED; ANGIOGRAPHY; ARTICLE; BLOOD CLOTTING TIME; BRAIN DAMAGE; CATHETER; CATHETER ABLATION; COMPARATIVE STUDY; FEMALE; FOLLOW UP; HEART ATRIUM ARRHYTHMIA; HEART ATRIUM FIBRILLATION; HUMAN; INCIDENCE; MAJOR CLINICAL STUDY; MALE; MEDICAL INSTRUMENTATION; NEUROIMAGING; NUCLEAR MAGNETIC RESONANCE IMAGING; NUCLEAR MAGNETIC RESONANCE SCANNER; PRIORITY JOURNAL; PROBABILITY; PULMONARY VEIN ISOLATION; RADIOFREQUENCY ABLATION; ROBOTIC NAVIGATION; ROBOTICS; SILENT CEREBRAL LESION; TREATMENT OUTCOME;

AGED; ATRIAL FIBRILLATION; CATHETER ABLATION; ELECTROCARDIOGRAPHY; EQUIPMENT DESIGN; FEMALE; FOLLOW-UP STUDIES; GERMANY; HEART CONDUCTION SYSTEM; HUMANS; INCIDENCE; MAGNETIC RESONANCE IMAGING; MALE; MIDDLE AGED; PROSPECTIVE STUDIES; PULMONARY VEINS; RISK FACTORS; ROBOTICS; STROKE; TIME FACTORS; TREATMENT OUTCOME;

EID: 84858321930     PISSN: 19413149     EISSN: 19413084     Source Type: Journal    
DOI: 10.1161/CIRCEP.111.967497     Document Type: Article

References (23)

1. Ouyang F, Tilz R, Chun J, Schmidt B, Wissner E, Zerm T, Neven K, Köktürk B, Konstantinidou M, Metzner A, Fuernkranz A, Kuck KH. Long-term results of catheter ablation in paroxysmal atrial fibrillation: Lessons from a 5-year follow-up. Circulation. 2010;122:2368-2377
2. Tilz RR, Chun KR, Schmidt B, Fuernkranz A, Wissner E, Koester I, Baensch D, Boczor S, Koektuerk B, Metzner A, Zerm T, Ernst S, Antz M, Kuck KH, Ouyang F. Catheter ablation of long-standing persistent atrial fibrillation: A lesson from circumferential pulmonary vein isolation. J Cardiovasc Electrophysiol. 2010;21:1085-1093
3. O'Neill MD, Jaïs P, Hocini M, Sacher F, Klein GJ, Clémenty J, Haïssaguerre M. Catheter ablation for atrial fibrillation. Circulation. 2007;116: 1515-1523 (Pubitemid 47480643)
4. Lickfett L, Hackenbroch M, Lewalter T, Selbach S, Schwab JO, Yang A, Balta O, Schrikel J, Bitzen A, Luderitz B, Sommer T. Cerebral diffusionweighted magnetic resonance imaging: A tool to monitor the thrombogenicity of left atrial catheter ablation. J Cardiovasc Electrophysiol. 2006; 17:1-7
5. Gaita F, Caponi D, Pianelli M, Scaglione M, Toso E, Cesarani F, Boffano C, Gandini G, Valentini MC, De Ponti R, Halimi F, Leclercq JF. Radiofrequency catheter ablation of atrial fibrillation: A cause of silent thromboembolism? Magnetic resonance imaging assessment of cerebral thromboembolism in patients undergoing ablation of atrial fibrillation. Circulation. 2010;122:1667-1673
6. Gaita F, Leclercq JF, Schumacher B, Scaglione M, Toso E, Halimi F, Schade A, Froehner S, Ziegler V, Sergi D, Cesarani F, Blandino A. Incidence of silent cerebral thromboembolic lesions after atrial fibrillation ablation may change according to technology used: Comparison of irrigated radiofrequency, multipolar nonirrigated catheter and cryoballoon. J Cardiovasc Electrophysiol. 2011;22:961-968
7. Herrera Siklódy C, Deneke T, Hocini M, Lehrmann H, Shin DI, Miyazaki S, Henschke S, Fluegel P, Schiebeling-Römer J, Bansmann PM, Bourdias T, Dousset V, Haïssaguerre M, Arentz T. Incidence of asymptomatic intracranial embolic events after pulmonary vein isolation comparison of different atrial fibrillation ablation technologies in a multicenter study. J Am Coll Cardiol. 2011;58:681-688
8. Rillig A, Meyerfeldt U, Kunze M, Birkemeyer R, Miljak T, Jäckle S, Hajredini B, Treusch F, Jung W. Persistent iatrogenic atrial septal defect after a single-puncture, double-transseptal approach for pulmonary vein isolation using a remote robotic navigation system: Results from a prospective study. Europace. 2010;12:331-336
9. Natale A, Raviele A, Arentz T, Calkins H, Chen S, Haissaguerre M, Hindricks G, Ho Y, Kuck KH, Marchlinski F, Napolitano C, Packer D, Pappone C, Prystowsky E, Schilling R, Shah D, Themistoclakis S, Verma A. Venice Chart International Consensus document on atrial fibrillation ablation. J Cardiovasc Electrophysiol. 2007;18:560-580 (Pubitemid 46650353)
10. Rillig A, Meyerfeldt U, Birkemeyer R, Treusch F, Kunze M, Brasch M, Jung W. Catheter ablation within the sinus of Valsalva: A safe and effective approach for treatment of atrial and ventricular tachycardias. Heart Rhythm. 2008;5:1265-1272
11. Schrickel JW, Lickfett L, Lewalter T, Mittman-Braun E, Selbach S, Strach K, Nähle CP, Schwab JO, Linhart M, Andrié R, Nickenig G, Sommer T. Incidence and predictors of silent cerebral embolism during pulmonary vein catheter ablation for atrial fibrillation. Europace. 2010; 12:52-57
12. Neumann T, Kuniss M, Conradi G, Janin S, Berkowitsch A, Wojcik M, Rixe J, Erkapic D, Zaltsberg S, Rolf A, Bachmann G, Dill T, Hamm CW, Pitschner HF. MEDAFI-Trial (Micro-Embolization During Ablation of Atrial Fibrillation): Comparison of pulmonary vein isolation using cryoballoon technique vs radiofrequency energy. Europace. 2011;13:37-44
13. Di Biase L, Natale A, Barrett C, Tan C, Elayi CS, Ching CK, Wang P, Al-Ahmad A, Arruda M, Burkhardt JD, Wisnoskey BJ, Chowdhury P, De Marco S, Armaganijan L, Litwak KN, Schweikert RA, Cummings JE. Relationship between catheter forces, lesion characteristics, "popping," and char formation: Experience with robotic navigation system. J Cardiovasc Electrophysiol. 2009;20:436-440
14. Sauren LD, Van Belle Y, DE Roy L, Pison L, LA Meir M, Van der Veen FH, Crijns HJ, Jordaens L, Mess WH, Maessen JG. Transcranial measurement of cerebral microembolic signals during endocardial pulmonary vein isolation: Comparison of three different ablation techniques. J Cardiovasc Electrophysiol. 2009;20:1102-1107
15. Wood MA, Shaffer KM, Ellenbogen AL, Ownby ED. Microbubbles during radiofrequency catheter ablation: Composition and formation. Heart Rhythm. 2005;2:397-403 (Pubitemid 40439286)
16. Boersma LV. Silent cerebral ischemia after AF ablation: No bubbles, no troubles? Heart Rhythm. 2011;8:1712-1713
17. Bruce CJ, Friedman PA, Narayan O, Munger TM, Hammill SC, Packer DL, Asirvatham SJ. Early heparinization decreases the incidence of left atrial thrombi detected by intracardiac echocardiography during radiofrequency ablation for atrial fibrillation. J Interv Card Electrophysiol. 2008; 22:211-219
18. Ren JF, Marchlinski FE, Callans DJ, Gerstenfeld EP, Dixit S, Lin D, Nayak HM, Hsia HH. Increased intensity of anticoagulation may reduce thrombus during atrial fibrillation ablation procedures patients with spontaneous echo contrast. J Cardiovasc Electrophysiol. 2005;16:474-477 (Pubitemid 40632478)
19. Rillig A, Meyerfeldt U, Birkemeyer R, Treusch F, Kunze M, Miljak T, Zvereva V, Jung W. Remote robotic catheter ablation for atrial fibrillation: How fast is it learned and what benefits can be earned? J Interv Card Electrophysiol. 2010;29:109-117
20. Schmidt B, Tilz RR, Neven K, Julian Chun KR, Fürnkranz A, Ouyang F. Remote robotic navigation and electroanatomical mapping for ablation of atrial fibrillation: Considerations for navigation and impact on procedural outcome. Circ Arrhythm Electrophysiol. 2009;2:120-128
21. Schwarz N, Kuniss M, Nedelmann M, Kaps M, Bachmann G, Neumann T, Pitschner HF, Gerriets T. Neuropsychological decline after catheter ablation of atrial fibrillation. Heart Rhythm. 2010;7:1761-1767
22. Deneke T, Shin DI, Balta O, Bünz K, Fassbender F, Mügge A, Anders H, Horlitz M, Päsler M, Karthikapallil S, Arentz T, Beyer D, Bansmann M. Postablation asymptomatic cerebral lesions: Long-term follow-up using magnetic resonance imaging. Heart Rhythm. 2011;8:1705-1711
23. Maleki K, Mohammadi R, Hart D, Cotiga D, Farhat N, Steinberg JS. Intracardiac ultrasound detection of thrombus on transseptal sheath: Incidence, treatment, and prevention. J Cardiovasc Electrophysiol 2005;16:561-565. (Pubitemid 40807642)