Format

Send to

Choose Destination
Stroke. 2012 Jan;43(1):265-70. doi: 10.1161/STROKEAHA.111.627067. Epub 2011 Dec 8.

Left atrial catheter ablation and ischemic stroke.

Author information

1
Department of Neurology, Charité-Universitätsmedizin Berlin, Hindenburgdamm 30, D-12200 Berlin, Germany. georg.haeusler@charite.de

Abstract

Left atrial catheter ablation (LACA) has become an established therapy to abolish drug-refractory symptomatic paroxysmal and persistent atrial fibrillation. Restoring sinus rhythm by LACA may help to prevent atrial fibrillation-related strokes, but presently there is no evidence from randomized clinical trials to support this notion. This review summarizes the current knowledge and uncertainties regarding LACA and procedure-related ischemic stroke. In fact, most patients who undergo LACA have a rather low annual stroke risk even when left untreated, whereas LACA imposes a risk of procedure-related stroke of ≈0.5% to 1%. In addition, LACA may cause cerebral microemboli, resulting in ischemic lesions. These cerebral lesions, detectable by high-resolution MRI, could contribute to neuropsychological deficits and cognitive dysfunction. Furthermore, recurrent atrial fibrillaton episodes can be detected up to years after LACA and might cause ischemic strokes, especially in those patients in whom therapeutic anticoagulation was discontinued. Further prospective multicenter trials are needed to identify procedure-dependent risk factors for stroke and to optimize postprocedural anticoagulation management.

PMID:
22156699
DOI:
10.1161/STROKEAHA.111.627067
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center