Transcranial measurement of cerebral microembolic signals during pulmonary vein isolation: A comparison of two ablation techniques

Circulation: Arrhythmia and Electrophysiology

Volumn 6, Issue 3, 2013, Pages 473-480

  Nagy Baló, Edina ^a   Tint, Diana ^a   Clemens, Marcell ^a   Beke, Ildikó ^a   Réka Kovács, Katalin ^a   Csiba, László ^a   Édes, István ^a   Csanádi, Zoltán ^a  

^a UNIVERSITY OF DEBRECEN   (Hungary)

Author keywords

Atrial fibrillation; Cerebral microemboli; Pulmonary vein isolation; Transcranial Doppler

Indexed keywords

ABLATION THERAPY; ADULT; ANTICOAGULATION; ARTICLE; BLOOD CLOTTING TIME; BRAIN EMBOLISM; CATHETER ABLATION; CLINICAL ARTICLE; CONTROLLED STUDY; CRYOBALLOON ABLATION; FEMALE; HUMAN; INTERMETHOD COMPARISON; INTRACARDIAC ECHOCARDIOGRAPHY; MALE; MICROEMBOLISM; PRIORITY JOURNAL; PROSPECTIVE STUDY; PULMONARY VEIN ISOLATION; RADIOFREQUENCY; TRANSCRANIAL DOPPLER; ANGIOGRAPHY; CEREBRAL MICROEMBOLI; COMPARATIVE STUDY; CONTROLLED CLINICAL TRIAL; DOPPLER ECHOGRAPHY; ECHOGRAPHY; ELECTROCARDIOGRAPHY; FOLLOW UP; HEART ATRIUM FIBRILLATION; METHODOLOGY; MIDDLE AGED; OPERATION DURATION; PATIENT MONITORING; PREOPERATIVE CARE; PULMONARY VEIN; RADIOGRAPHY; RANDOMIZED CONTROLLED TRIAL; RISK ASSESSMENT; SEVERITY OF ILLNESS INDEX; TREATMENT OUTCOME;

ANTICOAGULANT AGENT;

ATRIAL FIBRILLATION; CEREBRAL MICROEMBOLI; PULMONARY VEIN ISOLATION; TRANSCRANIAL DOPPLER;

ADULT; ANGIOGRAPHY; ANTICOAGULANTS; ATRIAL FIBRILLATION; CATHETER ABLATION; ELECTROCARDIOGRAPHY; FEMALE; FOLLOW-UP STUDIES; HUMANS; INTRACRANIAL EMBOLISM; MALE; MIDDLE AGED; MONITORING, INTRAOPERATIVE; OPERATIVE TIME; PREOPERATIVE CARE; PROSPECTIVE STUDIES; PULMONARY VEINS; RISK ASSESSMENT; SEVERITY OF ILLNESS INDEX; TREATMENT OUTCOME; ULTRASONOGRAPHY, DOPPLER, TRANSCRANIAL;

EID: 84882993483     PISSN: 19413149     EISSN: 19413084     Source Type: Journal    
DOI: 10.1161/CIRCEP.112.971747     Document Type: Article

References (25)

1. Kok LC, Mangrum JM, Haines DE, Mounsey JP. Cerebrovascular complication associated with pulmonary vein ablation. J Cardiovasc Electrophysiol. 2002;13:764-767.
2. 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.
3. 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.
4. 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.
5. 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.
6. Lickfett L, Hackenbroch M, Lewalter T, Selbach S, Schwab JO, Yang A, Balta O, Schrickel J, Bitzen A, Lüderitz 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.
7. Herrera Siklódy C, Deneke T, Hocini M, Lehrmann H, Shin DI, Miyazaki S, Henschke S, Kalusche D, Haissagure 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. 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.
9. 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. Transcranial Doppler detection of microembolic signals during pulmonary vein antrum isolation: implications for titration of radiofrequency energy. J Cardiovasc Electrophysiol. 2006;17:495-501.
10. 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.
11. Natale A, Raviele A, Arentz T, Calkins H, Chen SA, Haïssaguerre M, Hindricks G, Ho Y, Kuck KH, Marchlinski F, Napolitano C, Packer D, Pappone C, Prystowsky EN, Schilling R, Shah D, Themistoclakis S, Verma A. Venice Chart international consensus document on atrial fibrillation ablation. J Cardiovasc Electrophysiol. 2007;18:560-580.
12. 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 shortterm outcome. Eur Heart J. 2007;28:2231-2237.
13. Boersma LV, Wijffels MC, Oral H, Wever EF, Morady F. Pulmonary vein isolation by duty-cycled bipolar and unipolar radiofrequency energy with a multielectrode ablation catheter. Heart Rhythm. 2008;5:1635-1642.
14. Scharf C, Boersma L, Davies W, Kanagaratnam P, Peters NS, Paul W, Rowland E, Grace A, Fynn S, Dang L, Oral H, Morady F. Ablation of persistent atrial fibrillation using multielectrode catheters and duty-cycled radiofrequency energy. J Cardiovasc Electrophysiol. 2010;21:399-405.
15. Boersama L, Duytschaever M, Geller JC, Scarf C. The PVAC Workbook. London, UK: Remedica; 2010:1-21, 41-67.
16. Russell D, Brucher R. Online automatic discrimination between solid and gaseous cerebral microemboli with the first multifrequency transcranial Doppler. Stroke. 2002;33:1975-1980.
17. Markus HS, Punter M. Can transcranial Doppler discriminate between solid and gaseous microemboli? Assessment of a dual-frequency transducer system. Stroke. 2005;36:1731-1734.
18. 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.
19. 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.
20. Sauren LD, la Meir M, de Roy L, Pison L, van der Veen FH, Mess WH, Crijns HJ, Maessen JG. Increased number of cerebral emboli during percutaneous endocardial pulmonary vein isolation versus a thoracoscopic epicardial approach. Eur J Cardiothorac Surg. 2009;36:833-837.
21. Neville MJ, Butterworth J, James RL, Hammon JW, Stump DA. Similar neurobehavioral outcome after valve or coronary artery operations despite differing carotid embolic counts. J Thorac Cardiovasc Surg. 2001;121:125-136.
22. 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.
23. Anfinsen OG, Gjesdal K, Brosstad F, Orning OM, Aass H, Kongsgaard E, Amlie JP. The activation of platelet function, coagulation, and fibrinolysis during radiofrequency catheter ablation in heparinized patients. J Cardiovasc Electrophysiol. 1999;10:503-512.
24. Haines D. Biophysics of ablation: application to technology. J Cardiovasc Electrophysiol. 2004;15(10 suppl):S2-S11.
25. Haines DE, Watson DD. Tissue heating during radiofrequency catheter ablation: a thermodynamic model and observations in isolated perfused and superfused canine right ventricular free wall. Pacing Clin Electrophysiol. 1989;12:962-976.