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
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	silent cerebral embolism atrial fibrillation ablation technology robotic magnetic navigation catheter ablation Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/e5313535a2b74e35a95054b8bcce12dc
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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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Atrial Fibrillation Ablation Using Robotic Magnetic Navigation Reduces the Incidence of Silent Cerebral Embolism

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