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001-es BibID:	BIBFORM044122
035-os BibID:	PMID: 23580744
Első szerző:	Nagy-Baló Edina (kardiológus)
Cím:	Transcranial Measurement of Cerebral Microembolic Signals during Pulmonary Vein Isolation : a Comparison of Two Ablation Techniques / Edina Nagy-Baló, Diana Tint, Marcell Clemens, Ildikó Beke, Katalin Réka Kovács, László Csiba, István Édes, Zoltán Csanádi
Dátum:	2013
Megjegyzések:	BACKGROUND: -Pulmonary vein isolation (PVI) has increasingly been used to cure atrial fibrillation, but concerns have recently been raised that subclinical brain damage may occur due to microembolization during these procedures. We compared the occurrence of bubble formation seen on intracardiac echocardiography (ICE) and the microembolic signals (MESs) detected by transcranial Doppler on the use of different ablation techniques and anticoagulation strategies. METHODS AND RESULTS: -This prospective study included 35 procedures in 34 consecutive patients (age: 52, SD: 12.8 years; female:male 9:25). PVI was performed with a cryoballoon and the conventional anticoagulation protocol (ACT>250 s) in 10 procedures (Group 1), with a multipolar duty-cycled radiofrequency pulmonary vein ablation catheter (PVAC) and the conventional anticoagulation protocol in 12 procedures (Group 2), and with a PVAC with an aggressive anticoagulation regime (ACT>320 s) in 13 procedures (Group 3). The mean total numbers of MESs detected during the procedures were 833.7 (SD: 727.4) in Group 1, 3142.6 (SD: 1736.4) in Group 2 and 2204.6 (SD: 1078.1) in Group 3 (p=0.0005). MESs were detected mostly during energy delivery in the PVAC groups, while a relatively even distribution of emboli formation was seen during cryoballoon ablations. A significant correlation was found in all groups between the degree of bubble formation on ICE and the number of MESs (p=0.0000). CONCLUSIONS: -Duty-cycled RF ablation is associated with significantly more MESs, even when more aggressive anticoagulation is applied. With both techniques most of these microemboli are gaseous in nature.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Circulation. Arrhythmia and Electrophysiology. - 6 : 3 (2013), p. 473-480. -
További szerzők:	Tint, Diana Clemens Marcell (1979-) (kardiológus) Beke Ildikó (kardiológus) Czuriga-Kovács Katalin Réka (1981-) (neurológus) Csiba László (1952-) (neurológus, pszichiáter) Édes István (1952-) (kardiológus) Csanádi Zoltán (1960-) (kardiológus)
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat DOI
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