Atrial Fibrillation Ablation Using Robotic Magnetic Navigation Reduces the Incidence of Silent Cerebral Embolism

Background: The incidence of silent cerebral embolisms (SCEs) has been documented after pulmonary vein isolation using different ablation technologies; however, it is unreported in patients undergoing with atrial fibrillation (AF) ablation using Robotic Magnetic Navigation (RMN). The purpose of this...

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Autores principales: Jie Zheng, Meng Wang, Qun-feng Tang, Feng Xue, Ku-lin Li, Shi-peng Dang, Xiao-yu Liu, Xiao-xi Zhao, Chang-ying Zhang, Zhi-ming Yu, Bing Han, Ting-bo Jiang, Yan Yao, Ru-Xing Wang
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Publicado: Frontiers Media S.A. 2021
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spelling oai:doaj.org-article:e5313535a2b74e35a95054b8bcce12dc2021-12-01T22:46:43ZAtrial Fibrillation Ablation Using Robotic Magnetic Navigation Reduces the Incidence of Silent Cerebral Embolism2297-055X10.3389/fcvm.2021.777355https://doaj.org/article/e5313535a2b74e35a95054b8bcce12dc2021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.777355/fullhttps://doaj.org/toc/2297-055XBackground: The incidence of silent cerebral embolisms (SCEs) has been documented after pulmonary vein isolation using different ablation technologies; however, it is unreported in patients undergoing with atrial fibrillation (AF) ablation using Robotic Magnetic Navigation (RMN). The purpose of this prospective study was to investigate the incidence, risk predictors and probable mechanisms of SCEs in patients with AF ablation and the potential impact of RMN on SCE rates.Methods and Results: We performed a prospective study of 166 patients with paroxysmal or persistent AF who underwent pulmonary vein isolation. Patients were divided into RMN group (n = 104) and manual control (MC) group (n = 62), and analyzed for their demographic, medical, echocardiographic, and risk predictors of SCEs. All patients underwent cerebral magnetic resonance imaging within 48 h before and after the ablation procedure to assess cerebral embolism. The incidence and potential risk factors of SCEs were compared between the two groups. There were 26 total cases of SCEs in this study, including 6 cases in the RMN group and 20 cases in the MC group. The incidences of SCEs in the RMN group and the MC group were 5.77 and 32.26%, respectively (X2 = 20.63 P < 0.05). Univariate logistic regression analysis demonstrated that ablation technology, CHA2DS2-VASc score, history of cerebrovascular accident/transient ischemic attack, and low ejection fraction were significantly associated with SCEs, and multivariate logistic regression analysis showed that MC ablation was the only independent risk factor of SCEs after an AF ablation procedure.Conclusions: Ablation technology, CHA2DS2-VASc score, history of cerebrovascular accident/transient ischemic attack, and low ejection fraction are associated with SCEs. However, ablation technology is the only independent risk factor of SCEs and RMN can significantly reduce the incidence of SCEs resulting from AF ablation.Clinical Trial Registration: ChiCTR2100046505.Jie ZhengMeng WangQun-feng TangFeng XueKu-lin LiShi-peng DangXiao-yu LiuXiao-xi ZhaoChang-ying ZhangZhi-ming YuBing HanTing-bo JiangYan YaoRu-Xing WangFrontiers Media S.A.articlesilent cerebral embolismatrial fibrillationablation technologyrobotic magnetic navigationcatheter ablationDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution DOAJ
collection DOAJ
language EN
topic silent cerebral embolism
atrial fibrillation
ablation technology
robotic magnetic navigation
catheter ablation
Diseases of the circulatory (Cardiovascular) system
RC666-701
spellingShingle silent cerebral embolism
atrial fibrillation
ablation technology
robotic magnetic navigation
catheter ablation
Diseases of the circulatory (Cardiovascular) system
RC666-701
Jie Zheng
Meng Wang
Qun-feng Tang
Feng Xue
Ku-lin Li
Shi-peng Dang
Xiao-yu Liu
Xiao-xi Zhao
Chang-ying Zhang
Zhi-ming Yu
Bing Han
Ting-bo Jiang
Yan Yao
Ru-Xing Wang
Atrial Fibrillation Ablation Using Robotic Magnetic Navigation Reduces the Incidence of Silent Cerebral Embolism
description Background: The incidence of silent cerebral embolisms (SCEs) has been documented after pulmonary vein isolation using different ablation technologies; however, it is unreported in patients undergoing with atrial fibrillation (AF) ablation using Robotic Magnetic Navigation (RMN). The purpose of this prospective study was to investigate the incidence, risk predictors and probable mechanisms of SCEs in patients with AF ablation and the potential impact of RMN on SCE rates.Methods and Results: We performed a prospective study of 166 patients with paroxysmal or persistent AF who underwent pulmonary vein isolation. Patients were divided into RMN group (n = 104) and manual control (MC) group (n = 62), and analyzed for their demographic, medical, echocardiographic, and risk predictors of SCEs. All patients underwent cerebral magnetic resonance imaging within 48 h before and after the ablation procedure to assess cerebral embolism. The incidence and potential risk factors of SCEs were compared between the two groups. There were 26 total cases of SCEs in this study, including 6 cases in the RMN group and 20 cases in the MC group. The incidences of SCEs in the RMN group and the MC group were 5.77 and 32.26%, respectively (X2 = 20.63 P < 0.05). Univariate logistic regression analysis demonstrated that ablation technology, CHA2DS2-VASc score, history of cerebrovascular accident/transient ischemic attack, and low ejection fraction were significantly associated with SCEs, and multivariate logistic regression analysis showed that MC ablation was the only independent risk factor of SCEs after an AF ablation procedure.Conclusions: Ablation technology, CHA2DS2-VASc score, history of cerebrovascular accident/transient ischemic attack, and low ejection fraction are associated with SCEs. However, ablation technology is the only independent risk factor of SCEs and RMN can significantly reduce the incidence of SCEs resulting from AF ablation.Clinical Trial Registration: ChiCTR2100046505.
format article
author Jie Zheng
Meng Wang
Qun-feng Tang
Feng Xue
Ku-lin Li
Shi-peng Dang
Xiao-yu Liu
Xiao-xi Zhao
Chang-ying Zhang
Zhi-ming Yu
Bing Han
Ting-bo Jiang
Yan Yao
Ru-Xing Wang
author_facet Jie Zheng
Meng Wang
Qun-feng Tang
Feng Xue
Ku-lin Li
Shi-peng Dang
Xiao-yu Liu
Xiao-xi Zhao
Chang-ying Zhang
Zhi-ming Yu
Bing Han
Ting-bo Jiang
Yan Yao
Ru-Xing Wang
author_sort Jie Zheng
title Atrial Fibrillation Ablation Using Robotic Magnetic Navigation Reduces the Incidence of Silent Cerebral Embolism
title_short Atrial Fibrillation Ablation Using Robotic Magnetic Navigation Reduces the Incidence of Silent Cerebral Embolism
title_full Atrial Fibrillation Ablation Using Robotic Magnetic Navigation Reduces the Incidence of Silent Cerebral Embolism
title_fullStr Atrial Fibrillation Ablation Using Robotic Magnetic Navigation Reduces the Incidence of Silent Cerebral Embolism
title_full_unstemmed Atrial Fibrillation Ablation Using Robotic Magnetic Navigation Reduces the Incidence of Silent Cerebral Embolism
title_sort atrial fibrillation ablation using robotic magnetic navigation reduces the incidence of silent cerebral embolism
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/e5313535a2b74e35a95054b8bcce12dc
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