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001-es BibID:BIBFORM068008
Első szerző:Nagy-Baló Edina (kardiológus)
Cím:Cerebral micro-embolization during pulmonary vein isolation : relation to post-ablation silent cerebral ischemia / Edina Nagy-Baló, Mihran Martirosyan, Gábor Sándorfi, Orsolya Hajas, Levente Lánczi, Ervin Berényi, Lilla Ladányi, Alexandra Kiss, István Édes, Zoltán Csanádi
Dátum:2017
Megjegyzések:AbstractBackground: High incidences of silent cerebral ischemia (SCI) have been revealed bydiffusion-weighted magnetic resonance imaging (DW MRI) after pulmonary vein isolation(PVI) for atrial fibrillation. A high number of mostly gaseous micro-embolic signals (MESs)was detected by transcranial Doppler (TCD) during PVI. In this investigation the possiblerelationship between MESs detected intraoperatively by TCD and new SCI on DW MRI postablationis reported.Methods: 27 consecutive atrial fibrillation patients (6 female, age median: 64 interquartilerange: 13.23) undergoing PVI with the pulmonary vein ablation catheter (PVAC), pre- andpost-ablation DW MRI and intraoperative MES detection by TCD were included in the study.Procedures were performed on a therapeutic international normalized ratio (2?3) and with atarget activated clotting time ? 350 s in all patients. DW MRI scans performed pre- and postablationrevealed new SCI in 6 out of 27 (22%) patients.Results: The median (interquartile range) MES count recorded during the whole procedurewas 1642 (912) in patients with and 1019 (529) in those without SCI (p = 0.129). The numberof MESs recorded during PV angiography was significantly higher in patients as compared tothose without a new lesion on the post-ablation DW MRI: 257 (249) vs. 110 (71), respectively(p = 0.0009). On multivariate logistic regression, the total MES count was predictive of SCIin patients older than 68 years.Conclusions: Micro-embolus generation detected by TCD during PV angiographysignificantly correlates with new SCI on DW MRI post-ablation.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
silent cerebral ischemia
diffusion-weighted magnetic resonance imaging
transcranial Doppler
microembolic signals
Megjelenés:Cardiology Journal 24 : 3 (2017), p. 234-241. -
További szerzők:Martirosyan, Mihran (1984-) (orvos, kardiológus) Sándorfi Gábor (1976-) (belgyógyász, kardiológus) Hajas Orsolya (1987-) Lánczi Levente (1990-) (általános orvos) Berényi Ervin (1964-) (radiológus) Ladányi Lilla Kiss Alexandra (1987-) (általános orvos) Édes István (1952-) (kardiológus) Csanádi Zoltán (1960-) (kardiológus)
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