Universität zu Köln

Deneke, Thomas, Shin, Dong-In, Balta, Osman, Buenz, Kathrin, Fassbender, Frank, Muegge, Andreas, Anders, Helge, Horlitz, Marc, Paesler, Markus, Karthikapallil, Sinthu, Arentz, Thomas, Beyer, Dieter and Bansmann, Martin (2011). Postablation asymptomatic cerebral lesions: Long-term follow-up using magnetic resonance imaging. Heart Rhythm, 8 (11). S. 1705 - 1712. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1547-5271

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Abstract

BACKGROUND Catheter ablation of atrial fibrillation (AF) is complicated by cerebral emboli resulting in acute ischemia. Recently, cerebral ischemic microlesions have been identified with diffusion-weighted magnet resonance imaging (MRI). OBJECTIVE The clinical course and longer-term characteristics of these lesions are not known and were investigated in this study. METHODS Of 86 patients, 33 (38%) had new asymptomatic cerebral lesions documented on MRI after catheter ablation for AF; 14 of these 33 (42%) underwent repeat MRI at different time intervals (2 weeks to 1 year) during follow-up, and clinical symptoms as well as size and number of residual lesions were documented. RESULTS In postablation cerebral MRI, 50 new lesions were identified (3.6 lesions/patient) in 14 patients. No patient presented any neurological symptoms. Distribution of the lesions was predominantly in the left hemisphere (60%) and the cerebellum (26%); 52% of the lesions were small (<= 3 mm maximum diameter), 42% were medium (4 to 10 mm) and 3 lesions (6%) had a maximum diameter >10 mm. Follow-up MRI after a median of 3 months revealed 3 residual lesions in 3 of 14 patients corresponding to the large acute postablation lesions (>10 mm). The re-maining 47 of 50 (94%) of the small or medium-sized lesions were not detectable at follow-up evaluation. CONCLUSIONS Most asymptomatic cerebral lesions observed acutely after AF ablation procedures were <= 10 mm in diameter. 94% of all lesions healed without scarring at follow-up >2 weeks after ablation. The larger acute lesions produced chronic glial scars. Neither chronic nor acute lesions were associated with neurological symptoms.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Deneke, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Shin, Dong-In UNSPECIFIED UNSPECIFIED UNSPECIFIED Balta, Osman UNSPECIFIED UNSPECIFIED UNSPECIFIED Buenz, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Fassbender, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Muegge, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Anders, Helge UNSPECIFIED UNSPECIFIED UNSPECIFIED Horlitz, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Paesler, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Karthikapallil, Sinthu UNSPECIFIED UNSPECIFIED UNSPECIFIED Arentz, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Beyer, Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Bansmann, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-486110
DOI:	10.1016/j.hrthm.2011.06.030
Journal or Publication Title:	Heart Rhythm
Volume:	8
Number:	11
Page Range:	S. 1705 - 1712
Date:	2011
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1547-5271
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PULMONARY VEIN ISOLATION; PERSISTENT ATRIAL-FIBRILLATION; CATHETER ABLATION; RADIOFREQUENCY ENERGY; PREDICTORS; ISCHEMIA; DECLINE Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48611