title: Incidence and outcomes of cerebrovascular events complicating catheter ablation for atrial fibrillation.
abstract: OBJECTIVE
  Cerebrovascular complications are relatively uncommon, but severe adverse events are associated with catheter ablation of atrial fibrillation (AF). This study aimed to investigate the incidence, risk factors, and hospital outcomes of cerebrovascular events complicating AF ablation.
  
  
  RESULTS
  Cerebrovascular complications occurring during the procedure or hospitalization after AF ablation were assessed. Cerebrovascular events occurred in 9 of 1946 consecutive procedures (0.46%). Seven patients (0.36% per procedure) were diagnosed with ischaemic stroke and two patients (0.1% per procedure) with intracranial haemorrhage (ICH). Six events (6/9, 66.7%) occurred during the ablation and the remainders within 24 h after the ablation. Multivariable analysis revealed that previous ischaemic stroke [odds ratio (OR) 10.549; 95% confidence interval (CI) 2.551-43.625, P = 0.001] and mechanical valve replacement (OR 3.261; 95% CI 1.337-7.953, P = 0.009) were independent predictors. In a separate model, CHA2DS2-VASc score ≥3 (OR 7.992; 95% CI 2.046-31.215, P = 0.003) and mechanical valve replacement (OR 4.104; 95% CI 1.644-10.245, P = 0.002) were significantly associated with cerebrovascular complications. All patients survived to discharge except the two cases with ICH.
  
  
  CONCLUSIONS
  Cerebrovascular complications related to catheter ablation of AF are relatively infrequent and typically occur early either during the procedure or within the first 24 h after AF ablation. Previous ischaemic stroke, mechanical valve replacement, and CHA2DS2-VASc score ≥3 are independent predictors of such complications. The majority of these events are ischaemic stroke with a benign clinical outcome, while ICH may correlate with poor prognosis.
authors.affiliation: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China.
authors.forename: Xianzhang
authors.initials: X
authors.lastname: Zhan
authors.affiliation: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China.
authors.forename: Yumei
authors.initials: Y
authors.lastname: Xue
authors.affiliation: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Deng
authors.affiliation: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China.
authors.forename: Xianhong
authors.initials: X
authors.lastname: Fang
authors.affiliation: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Liao
authors.affiliation: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Huang
authors.affiliation: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China.
authors.forename: Fangzhou
authors.initials: F
authors.lastname: Liu
authors.affiliation: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China.
authors.forename: Yuanhong
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.affiliation: Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou 510080, China wslgdci@163.com.
authors.forename: Shulin
authors.initials: S
authors.lastname: Wu
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D001706:Biopsy; D002545:Brain Ischemia / Q000453:epidemiology; D017115:Catheter Ablation / Q000009:adverse effects*; D002533:Cerebral Angiography / Q000379:methods; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D002681:China / Q000453:epidemiology; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D020300:Intracranial Hemorrhages / Q000453:epidemiology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Atrial fibrillation; Catheter ablation; Cerebrovascular complications