Background: The prevalence of cerebral microbleeds (CMBs) is significantly higher in patients with atrial fibrillation (AF) than in those without AF. CMBs in patients with AF have been reported to be primarily of the lobar type, but the exact cause of this remains unknown. We investigated the possibility that hemorrhagic transformation of embolic microinfarction can account for lobar CMBs.
Methods: A total of 101 patients who underwent ablation therapy for AF were prospectively registered, and 72 patients completed the assessment with MRI 6 months after catheter ablation. Brain MRI, including diffusion-weighted imaging (DWI) and susceptibility-weighted imaging (SWI), were examined at 1-3 days (baseline) and 6 months after catheter ablation. We quantitatively evaluated the spatial and temporal distribution of embolic microinfarctions and CMBs.
Results: Of the 101 patients, 68 were enrolled in this study. Fifty-nine patients (86.8%) showed embolic microinfarctions on baseline DWI immediately after catheter ablation. There were 137 CMBs in SWI, and 96 CMBs were of the lobar type. Six months later, there were 208 CMBs, including 71 CMBs, and 60 of 71 (84.5%) were of the lobar type. Of the 71 CMBs, 56 (78.9%) corresponded to the location of previous embolic microinfarctions found on baseline DWI. The platelet count was significantly lower and hematocrit/hemoglobin and Fazekas score were higher in the group with CMBs than in the group without CMBs.
Conclusion: CMBs frequently appeared after catheter ablation therapy. Our results suggest that embolic microinfarction can cause lobar CMBs.
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http://dx.doi.org/10.3389/fncel.2022.818288 | DOI Listing |
Eur Heart J Case Rep
January 2025
Department of Cardiology, Hyogo Prefectural Awaji Medical Center, Sumoto, Japan.
Background: Atrial infarction is a complication of myocardial infarction with ventricular infarction; however, isolated atrial infarction (IAI) has rarely been reported. Herein, we report a case of IAI associated with sick sinus syndrome and atrial fibrillation (AF).
Case Summary: An 83-year-old woman was brought to the emergency department with a complaint of general malaise.
Int J Cardiol
January 2025
Arrhythmias and Electrophysiology Unit, Division of Cardiology, IRCCS Fondazione Policlinico S. Matteo, Pavia, Italy. Electronic address:
Background: Although catheter ablation (CA) by mean of pulmonary vein isolation (PVI) is nowadays the mainstay treatment for atrial fibrillation (AF), its success-rate in persistent AF remains suboptimal. Results from studies evaluating whether adding posterior wall isolation (PWI) to PVI can increase the success-rate of CA in persistent AF have yielded conflicting data. The aim of this meta-analysis was to assess whether PWI plus PVI might be beneficial in patients with persistent AF.
View Article and Find Full Text PDFCardiol Rev
January 2025
Department of Cardiology, Detroit Medical Center, Detroit, MI.
Congenital heart disease (CHD) is the most common congenital anomaly in newborns. Advances in catheter and surgical techniques led to the majority of these patients surviving into adulthood, leading to evolving challenges due to the emergence of long-term complications such as arrhythmias. Interventional electrophysiology (EP) has had remarkable advances over the last few decades, and various techniques and devices have been explored to treat adult patients with CHD.
View Article and Find Full Text PDFCureus
December 2024
Internal Medicine, Hurley Medical Center, Flint, USA.
Catheter ablation procedure for symptomatic atrial fibrillation is an established treatment. Cardiac tamponade is one of the several complications associated with atrial fibrillation ablation. We present the case of a 60-year-old male with a past medical history of end-stage renal disease (ESRD) on hemodialysis, hypotension on midodrine, atrial fibrillation status post-ablation a week prior, and a cerebrovascular accident who presented to the emergency department with complaints of weakness, nausea, vomiting, confusion and some syncopal episodes for the past few days.
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