Safety of Catheter Ablation for Atrial Fibrillation in Patients With Prior Cerebrovascular Events.

JACC. Clinical Electrophysiology
Ayman HusseinNiraj Varma

Abstract

This study sought to report on the safety of catheter ablation for atrial fibrillation (AF) in patients with prior cerebrovascular events (CVEs), at a large-volume tertiary care center over the course of the past 15 years. Many patients with drug-refractory AF have a history of a prior CVE. These patients are considered to be at high procedural risk for catheter ablation but data are scant. All consecutive patients undergoing AF ablation at the Cleveland Clinic were enrolled in a prospectively maintained data registry, which was used to identify patients with a prior CVE. Strict periprocedural anticoagulation protocols were in place. Extreme care was taken with sheath and catheter manipulation to prevent thrombus formation or air embolism. All thromboembolic and hemorrhagic events occurring periprocedurally and up to 3 months of follow-up were identified. Of 9,413 consecutive patients who underwent AF ablation, 247 patients with a prior CVE were identified (median age, 64 years; 40.1% female; median CHA2DS2-VASC score, 4). Anticoagulants used were warfarin (n = 192), dabigatran (n = 32), rivaroxaban (n = 15), and apixaban (n = 8). All patients received intravenous heparin before transseptal access (activated clotting time targe...Continue Reading

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Citations

Nov 4, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Vassilios P VassilikosUNKNOWN AFA LT registry investigators group

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