Risk factors and localization of silent cerebral infarction in patients with atrial fibrillation

Abstract Aims Cryoballoon ablation (CBA) is effective for atrial fibrillation (AF), however acute silent cerebral infarction (SCI) is not uncommon after CBA. This study aimed to clarify the relationship between the morphology of LAA and SCI. Methods and results From 2015 to 2019, 207 consecutive patients (65.1±11.4 years, 26.6% of female, 31.4% of persistent AF) who underwent CBA for AF at our hospital were enrolled. All patients were evaluated with computed tomography for LAA before CBA and divided into two groups as chicken wing (CW) group and non-CW group. SCI was evaluated with magnetic resonance imaging at the following day after CBA. As a result, 18.4% of patients have occurred SCI after CBA. Although the patients' background didn't differ between the two groups, the Hounsfield scale (LAA/Aorta ratio) was lower (non-CW vs. CW = 0.68±0.12 vs. 0.73±0.11, p=0.004), and LAA orifice size tended to be larger (16.9±4.6 vs. 15.8±4.1, p=0.053) in non-CW group. SCI significantly occurred in non-CW group (29.5% vs. 11.6%, p=0.003), especially in cauliflower shape of 45.0%. In multivariate analysis, non-CW (p=0.002, Odds ratio 3.2, 95% of CI 1.5–7.0), skipped DOAC before CBA (p=0.04, Odds ratio 6.1, 95% of CI 1.1–115.4), and touch-up ablation in left atrium (p=0.02, Odds ratio 2.8, 95% CI 1.2–6.5) were independent predictors of SCI. Conclusions SCI was not rare after CBA for AF. Morphology of LAA was strongly associated with SCI. Funding Acknowledgement Type of funding source: None

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CEREBRAL INFARCTION;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.10.772 ◽

2017 ◽

Vol 24 (10) ◽

pp. 1484-1488

Author(s):

Muhammad Adnan Sarwar ◽

Huma Muzaffar ◽

Shakeel Ahmad

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Atrial Fibrillation ◽

Risk Factor ◽

Heart Disease ◽

Cerebral Infarction ◽

Cross Sectional Survey ◽

Common Risk Factor ◽

Cross Sectional ◽

Medical College

Objectives: To determine the frequency of different risk factors among patientsof stroke due to cerebral infarction. Study Design: Descriptive cross sectional survey. Setting:Punjab Medical College and affiliated hospitals (Allied Hospital and DHQ), Faisalabad. Durationwith Dates: Six months from June 2006 to November 2006. Methods: This was a crosssectional survey that included 195 patients with stroke due to cerebral infarction. The mainoutcome variable was frequency of different risk factors which were described as frequencydistribution table. Results: Hypertension was seen among 142 (73%) patients, followed bydiabetes mellitus in 83 42.5% patients, ischemic heart disease in 74 (38%) patients, smokingin 59 (30.3%) patients, obesity in 53(27%) patients, atrial fibrillation in 43 (22%) patients anddyslipidemia in 23 (11.8%). Conclusion: Hypertension is the most common risk factor followedby diabetes mellitus associated with stroke due to cerebral infarction.

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