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Keywords:

  • atrial fibrillation;
  • cryoballoon;
  • laser;
  • catheter ablation;
  • stroke;
  • microemboli

Asymptomatic Cerebral Lesions in AF Ablation

Background

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).

Conclusion

In this prospective, randomized, single-center pilot study, ablation technology did not influence the occurrence of ACL during AF ablation.