Bibliographic Details
| Title: |
Abstract 12886: Effect of Pre-Procedure Transesophageal Echocardiography on the Risk of Stroke After Atrial Fibrillation Ablation. |
| Authors: |
Gheith, Zaid1 (AUTHOR), Alqam, Bilal1 (AUTHOR), Habash, Fuad1 (AUTHOR), Khaled, Khaldia1 (AUTHOR), Abualsuod, Amjad2 (AUTHOR), Madmani, Mohammed2 (AUTHOR), Vallurupalli, Srikanth2 (AUTHOR), Maskoun, Waddah3 (AUTHOR) |
| Source: |
Circulation. 2018 Supplement, Vol. 138, pA12886-A12886. 1p. |
| Subject Terms: |
*TRANSIENT ischemic attack, *ATRIAL fibrillation, *STROKE, *TRANSESOPHAGEAL echocardiography, *VETERANS' hospitals, *AGE differences |
| Abstract: |
Background: Ischemic stroke/transient ischemic attack (CVA) is a known complication of atrial fibrillation (AF) ablation. Mechanisms include procedural complications (introduction of air, char and clot formation) and disruption of a preexisting thrombus in the left atrium, even in anticoagulated patients,. There is no consensus whether a transesophageal Echocardiography (TEE) should be performed in all patients undergoing AF ablation and if doing so would significantly reduce the risk of CVA. Methods: This was a retrospective study of patients who underwent AF ablation in the VA healthcare system between 2013-2017 (ICD9 diagnosis code 427.31 and procedure code 37.34). Risk of CVA (within 48 hours and at 1 month) was compared between those with and without a pre-procedural TEE. Results: 1069 ablations were performed for 921 patients at 34 VA hospitals. Patients were predominantly men (97.3%), aged 64±8 years with a mean CHA2DS2VASc score 2.3±1.6. TEE was performed prior to 74% of the ablations (of which, 66% on day of ablation and 34% the day prior). There was no significant baseline difference in age, baseline LV ejection fraction or CHA2DS2 - VASc. The overall incidence of CVA within 48 hours post ablation was 0.3% (no hemorrhagic strokes). There was no significant difference in CVA between the TEE vs no TEE groups at 48 hours (0.25% vs 0.37%, p=0.75, figure). 2 patients fully recovered while 1 patient died. After 48 hours from ablation no new CVA occurred within 1 month or between 1-12 months post ablation. Conclusions: The risk of CVA complicating AF ablation is relatively small and performing a TEE did not appear to significantly modify this risk. Incidence of CVA between 1-12 months after AF ablation was less than expected for comparable CHA2DS2VASc patients on anticoagulation alone. [ABSTRACT FROM AUTHOR] |
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