S.B. was supported by a grant from the European Heart Rhythm Association.
A Prospective Randomized Single-Center Study on the Risk of Asymptomatic Cerebral Lesions Comparing Irrigated Radiofrequency Current Ablation with the Cryoballoon and the Laser Balloon
Version of Record online: 18 APR 2013
© 2013 Wiley Periodicals, Inc.
Journal of Cardiovascular Electrophysiology
Volume 24, Issue 8, pages 869–874, August 2013
How to Cite
SCHMIDT, B., GUNAWARDENE, M., KRIEG, D., BORDIGNON, S., FÜRNKRANZ, A., KULIKOGLU, M., HERRMANN, W. and CHUN, K.R. J. (2013), A Prospective Randomized Single-Center Study on the Risk of Asymptomatic Cerebral Lesions Comparing Irrigated Radiofrequency Current Ablation with the Cryoballoon and the Laser Balloon. Journal of Cardiovascular Electrophysiology, 24: 869–874. doi: 10.1111/jce.12151
B.S. and K.R.J.C. received research grants and speaker honoraria from CardioFocus and are both consultants to Medtronic. A.F. is a consultant to Medtronic. Other authors: No disclosures.
CLINICAL TRIAL REGISTRATION: (https://drks-neu.uniklinik-freiburg.de/drks_web/; study number 00000782).
- Issue online: 22 JUL 2013
- Version of Record online: 18 APR 2013
- Accepted manuscript online: 25 MAR 2013 08:59PM EST
- Manuscript Accepted: 13 MAR 2013
- Manuscript Revised: 8 MAR 2013
- Manuscript Received: 11 FEB 2013
- European Heart Rhythm Association
- atrial fibrillation;
- catheter ablation;
Asymptomatic Cerebral Lesions in AF Ablation
Asymptomatic cerebral lesions (ACL) may occur during atrial fibrillation (AF) ablation. We sought to compare the ACL incidence between 3 contemporary technologies: (1) irrigated radiofrequency current (RFC), (2) the single big cryoballoon (CB), and (3) the endoscopic laser-balloon (LB) in a prospective randomized pilot study.
Methods and Results
Ninety-nine patients were treated in 3 groups. Diffusion weighted MRI was acquired pre- (n = 20) and 24–48 h postablation (n = 99).
After ablation, new ACL were detected in 22% of patients without significant differences between groups (RFC 8/33; CB 6/33; LB 8/33; P = 0.8). The presence of hypertension was identified as the only independent predictor of ACL by univariate regression analysis.
During LB ablation, more ablation lesions (140 ± 19 vs 119 ± 18; P = 0.007) were applied during longer procedures (166 ± 36 vs 143 ± 32 min; P = 0.05) in patients with ACL. Univariate analysis revealed that a higher number of ablation lesions predicted ACL (P = 0.02).
In this prospective, randomized, single-center pilot study, ablation technology did not influence the occurrence of ACL during AF ablation.