Objective: We had the objective to determine the impact of clinical parameters and anticoagulation status on cerebral microembolic signals (MES) during pulmonary vein isolation (PVI) for atrial fibrillation (AF).
Background: Thromboembolism and stroke are the most feared complications of PVI. MES can help to evaluate embolic burden. It is unknown whether clinical parameters have an impact on embolic risk during PVI.
Methods: In this retrospective analysis we investigated the impact of clinical parameters, including the CHADS2- and CHA2DS2-VASc-score, pulmonary vein variants and echocardiographic parameters on MES rates in patients that underwent PVI using three different ablation approaches (radiofrequency ablation (iRF), pulmonary vein ablation catheter (PVAC) with deactivated electrode pair 1 or 5 (PVAC-red) or PVAC without deactivation (PVAC-all).
Results: 118 AF patients (61±12 years) were included between 2011 and 2013 (Median: 489 MES during PVI). Patients were more likely to have more MES (within 4th quartile) with the PVAC-all approach (60.7% vs. 25.0% (iRF) vs. 14.3% (PVAC-red) respectively (p<0.001). Patients with oral anticoagulation (OAC) pre-ablation were more likely to have lower MES-counts (1st-3rd quartile); (65.6% vs. 35.7%; p = 0.005). Additionally, patients with lower MES counts (1st-3rd quartile) had significantly higher INR values than those in the 4th quartile (1.78 vs. 1.09; p = 0.029). 2 patients developed a potentially thromboembolic event during the procedure.
Conclusion: Clinical predictors of cerebral emboli and stroke do not correlate with cerebral embolic burden during PVI. Pre-ablation OAC and increased INR values correlate with decreased MES-rates. Therefore, it might be beneficial to perform PVI with pre-ablation anticoagulation even in low risk patients.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4915682 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0157886 | PLOS |
Publication Analysis
Top Keywords
Similar Publications
Implications of Genetic, Biological and Clinical Parameters in Patients With Richter Syndrome: A Monocentric Experience.
Hematol Oncol
January 2025
Dipartimento di scienze di laboratorio ed ematologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, UOSD Leucemia Linfatica Cronica, Roma, Italy.
Flexible progestin-primed ovarian stimulation versus a GnRH antagonist protocol in predicted suboptimal responders undergoing freeze-all cycles: a randomized non-inferiority trial.
Hum Reprod
December 2024
Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China.
Study Question: Are live birth rates (LBRs) per woman following flexible progestin-primed ovarian stimulation (fPPOS) treatment non-inferior to LBRs per woman following the conventional GnRH-antagonist protocol in expected suboptimal responders undergoing freeze-all cycles in assisted reproduction treatment?
Summary Answer: In women expected to have a suboptimal response, the 12-month likelihood of live birth with the fPPOS treatment did not achieve the non-inferiority criteria when compared to the standard GnRH antagonist protocol for IVF/ICSI treatment with a freeze-all strategy.
What Is Known Already: The standard PPOS protocol is effective for ovarian stimulation, where medroxyprogesterone acetate (MPA) is conventionally administered in the early follicular phase for ovulatory suppression. Recent retrospective cohort studies on donor cycles have shown the potential to prevent premature ovulation and maintain oocyte yields by delaying the administration of MPA until the midcycle (referred to as fPPOS), similar to GnRH antagonist injections.
Automatic calculation method for stenosis ratio based on dialysis access ultrasound image segmentation.
Med Phys
December 2024
Department of Echocardiography, Ultrasound Diagnostic Center, The First Hospital of Jilin University, Changchun, China.
Background: Dialysis Access (DA) stenosis impacts hemodialysis efficiency and patient health, necessitating exams for early lesion detection. Ultrasound is widely used due to its non-invasive, cost-effective nature. Assessing all patients in large hemodialysis facilities strains resources and relies on operator expertise.
View Article and Find Full Text PDFEffect of glyceryl trinitrate and clevidipine administration on CT angiogram findings in dogs undergoing prostatic artery embolization for prostatic carcinoma.
PLoS One
December 2024
Department of Surgical and Radiological Sciences, From the University of California-Davis, School of Veterinary Medicine, Davis, Davis, California, United States of America.
Objectives: The primary aim of this study was to evaluate the effects of vasodilator administration on CT angiography (CTA) prostatic artery diameter and peak opacification in dogs with prostatic carcinoma prior to prostatic artery embolization (PAE).
Materials And Methods: A prospective clinical trial was performed. Ten dogs with naturally occurring prostatic carcinoma and no evidence of cardiovascular disease were enrolled.
Evaluation of Soluble Tumor Necrosis Factor-Like Weak Inducer of Apoptosis, Omentin, and Tumor Necrosis Factor-α in Subjects with Periodontitis and Type 2 Diabetes Mellitus.
Genet Test Mol Biomarkers
December 2024
SRM Dental College, Bharathi Salai, Chennai, India.
Periodontal disease worsens glycemic control due to the bidirectional link between periodontitis and type 2 diabetes mellitus (T2DM), involving inflammatory markers such as soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK), tumor necrosis factor-α (TNF-α), and omentin-1. However, their combined role in T2DM with periodontitis has not been studied. This study aimed to evaluate the levels of these biomarkers in periodontitis patients with T2DM before and after nonsurgical periodontal therapy (NSPT).
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!