Long-term functional and neurocognitive recovery in patients who had an acute cerebrovascular event secondary to catheter ablation for atrial fibrillation.
BACKGROUND
Cerebral thromboembolic event (CTE) is a possible complication of pulmonary vein antrum isolation (PVAI). The objective of this study was to report long-term functional and neurocognitive recovery in patients who had a CTE during or within 48 hours of catheter ablation.


RESULTS
We screened 3,060 patients who underwent PVAI between January 2000 and June 2007. Out the 3,060 patients, 26 patients (0.8%) (61 +/- 8 years, 88% males) had a CTE during or within 48 hours of the procedure. We followed these 26 patients (study group) over time and assessed their functional and neurocognitive recovery status. No preferential vascular territory for the site of obstruction was found; right anterior circulation-5 patients (26%), left anterior circulation-5 patients (26%), posterior circulation-3 patients (16%), and 2 or more territories-6 patients (32%), (P-value = 0.8). The average international normalized ratio at the time of CTE was 1.33 +/- 0.4. Two patients died during the study period. At the end of 38.4 +/- 24 months follow-up, most surviving patients had complete neurocognitive and functional recovery irrespective of the severity of periprocedural stroke.


CONCLUSIONS
Periprocedural stroke in the setting of catheter ablation for atrial fibrillation is relatively rare. When it occurs, complete functional and neurocognitive recovery over time is the likely outcome for most patients.
Patel
Dimpi
D
Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA.
Bailey
Shane M
SM
Furlan
Anthony J
AJ
Ching
Marilou
M
Zachaib
Jonathan
J
Di Biase
Luigi
L
Mohanty
Prasant
P
Horton
Rodney P
RP
Burkhardt
J David
JD
Sanchez
Javier E
JE
Zagrodzky
Jason D
JD
Gallinghouse
G Joseph
GJ
Schweikert
Robert
R
Saliba
Walid
W
Natale
Andrea
A
D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology*; D009820:Ohio / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D020127:Recovery of Function; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000453:epidemiology*