title: Predictors of asymptomatic cerebral infarction associated with radiofrequency catheter ablation for atrial fibrillation using an irrigated-tip catheter.
abstract: OBJECTIVE
  Catheter ablation is a potentially curative treatment for atrial fibrillation (AF). However, complications such as ischaemic stroke are more frequent and more severe compared with ablation procedures for other arrhythmias. Irrigated-tip catheters have been reported to reduce the risk of stroke. The present study aimed to evaluate predictors of asymptomatic cerebral infarction (CI) after AF ablation using an irrigated-tip catheter.
  
  
  RESULTS
  A total of 70 consecutive AF patients who underwent catheter ablation were subjected to brain magnetic resonance imaging (MRI) 1 day after the procedure. In 10 (14.3%) of 70 patients, MRI revealed acute CI, but neither symptoms nor abnormal neurological findings were present in these patients. In univariate analysis, a history of persistent AF, left atrial dimension, presence of spontaneous echo contrast (SEC), procedure duration prior to heparin injection, and electrical cardioversion during the procedure differed significantly between the two groups, those with and without CI (P = 0.02, 0.05, 0.01, 0.01, and 0.05, respectively). Multivariate logistic regression analysis identified SEC [odds ratio (OR), 9.39; 1.60-55.2; P = 0.01] and procedure duration prior to heparin injection (OR, 1.19; 1.04-1.36; P = 0.01) as predictive of acute asymptomatic CI after AF ablation.
  
  
  CONCLUSIONS
  The presence of SEC and procedure duration prior to heparin injection are determinants of asymptomatic CI during AF ablation despite the use of an irrigated-tip catheter.
authors.affiliation: Division of Cardiology,  Gunma Prefectural Cardiovascular Center, 3-12 Kameizumimachi-kou, Maebashi 371-0004,  Japan.
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Koji
authors.initials: K
authors.lastname: Kumagai
authors.forename: Suguru
authors.initials: S
authors.lastname: Nishiuchi
authors.forename: Etsuko
authors.initials: E
authors.lastname: Fuke
authors.forename: Yuko
authors.initials: Y
authors.lastname: Miki
authors.forename: Keijiro
authors.initials: K
authors.lastname: Nakamura
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kaseno
authors.forename: Keiko
authors.initials: K
authors.lastname: Koyama
authors.forename: Shigeto
authors.initials: S
authors.lastname: Naito
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue
authors.forename: Shigeru
authors.initials: S
authors.lastname: Oshima
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage; D058070:Asymptomatic Diseases; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000601:surgery*; D062906:Cardiac Catheters; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation; D002544:Cerebral Infarction / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D016009:Chi-Square Distribution; D038524:Diffusion Magnetic Resonance Imaging; D004867:Equipment Design; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007275:Injections, Intravenous; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D007507:Therapeutic Irrigation / Q000009:adverse effects / Q000295:instrumentation; D013997:Time Factors; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D000925:Anticoagulants; D014859:Warfarin; D006493:Heparin