title: Long-term functional and neurocognitive recovery in patients who had an acute cerebrovascular event secondary to catheter ablation for atrial fibrillation.
abstract: 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.
authors.affiliation: Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, Texas, USA.
authors.forename: Dimpi
authors.initials: D
authors.lastname: Patel
authors.forename: Shane M
authors.initials: SM
authors.lastname: Bailey
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Furlan
authors.forename: Marilou
authors.initials: M
authors.lastname: Ching
authors.forename: Jonathan
authors.initials: J
authors.lastname: Zachaib
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.forename: Prasant
authors.initials: P
authors.lastname: Mohanty
authors.forename: Rodney P
authors.initials: RP
authors.lastname: Horton
authors.forename: J David
authors.initials: JD
authors.lastname: Burkhardt
authors.forename: Javier E
authors.initials: JE
authors.lastname: Sanchez
authors.forename: Jason D
authors.initials: JD
authors.lastname: Zagrodzky
authors.forename: G Joseph
authors.initials: GJ
authors.lastname: Gallinghouse
authors.forename: Robert
authors.initials: R
authors.lastname: Schweikert
authors.forename: Walid
authors.initials: W
authors.lastname: Saliba
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
mesh_terms: 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*