Higher Incidence of Asymptomatic Cerebral Emboli After Atrial Fibrillation Ablation Found With High-Resolution Diffusion-Weighted Magnetic Resonance Imaging
机构:[1]Division of Cardiology,the First Affiliated Hospital of Nanjing Medical University, PR China.江苏省人民医院[2]Division of Radiology,the First Affiliated Hospital of Nanjing Medical University, PR China.江苏省人民医院[3]Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, PR China[4]Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, PR China[5]Division of Cardiology, Ng Teng Fong General Hospital, Singapore[6]Division of Cardiology, Yunnan Arrhythmia Research Center, the First People’s Hospital of Yunnan Province, PR China云南省第一人民医院心血管内科内科片
Background: Asymptomatic cerebral emboli (ACE) are commonly seen on cerebral magnetic resonance imaging (MRI) after atrial fibrillation ablation, but the incidence in previous studies varies widely. No data exists to compare the effects of different diffusion-weighted imaging (DWI) settings on detecting ablation-related ACE. This self-control study sought to compare the incidence and characteristics of ablation-related ACE between high-resolution DWI and conventional DWI. Methods: A total of 55 consecutive patients referred for atrial fibrillation ablation between December 2017 and September 2018 were enrolled. Patients underwent high-resolution DWI 1 day before ablation and repeated high-resolution DWI and conventional DWI within 48 hours post-ablation. The incidence, number, size, and location of ACE were compared between 2 DWI settings in the same patients. Results: The high-resolution DWI revealed a higher incidence of acute ACE compared with conventional DWI (67.3% versus 41.8% of patients, P<0.001) and significantly more ACE (106 versus 45 lesions, P=0.001). For ACE seen on both scans, the size measured by high-resolution DWI was larger (5.42 versus 4.21 mm, P<0.001). No patients had any impaired neurocognitive performance during follow-up. Impaired left ventricular ejection fraction (P=0.012) and low intraoperative activated clotting time (P=0.009) level were associated with the occurrence of ACE in a multivariate analysis. Conclusions: High-resolution DWI revealed a higher incidence and greater details of post-ablation ACE in patients with atrial fibrillation. MRI settings significantly impact the detection of ACE and should be considered when comparing incidence rates of ACE among different studies.
基金:
This work was supported by grants from the National Natural Science Foundation
of China (grant number 81400253, 81800246), the Natural Science Foundation
of Jiangsu Province (grant number BK20141029), the Top-level Clinical Discipline
Project of Shanghai Pudong District (PWYgf2018-02), and the Scientific Research
Program for 333 Project of Jiangsu Province (grant number BRA2017190).
第一作者机构:[1]Division of Cardiology,the First Affiliated Hospital of Nanjing Medical University, PR China.
共同第一作者:
通讯作者:
通讯机构:[1]Division of Cardiology,the First Affiliated Hospital of Nanjing Medical University, PR China.[3]Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, PR China[6]Division of Cardiology, Yunnan Arrhythmia Research Center, the First People’s Hospital of Yunnan Province, PR China[*1]Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Rd, Shanghai 200120, PR China[*2]Division of Cardiology, Yunnan Arrhythmia Research Center, the First People’s Hospital of Yunnan Province, the Affiliated Hospital of Kunming, University of Science and Technology, 157 Jinbi Rd, Kunming, Yunnan 650032, PR China
推荐引用方式(GB/T 7714):
Yaya Yu,Xuecheng Wang,Xiaorong Li,et al.Higher Incidence of Asymptomatic Cerebral Emboli After Atrial Fibrillation Ablation Found With High-Resolution Diffusion-Weighted Magnetic Resonance Imaging[J].CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY.2020,13(1):doi:10.1161/CIRCEP.119.007548.
APA:
Yaya Yu,Xuecheng Wang,Xiaorong Li,Xiujuan Zhou,Shengen Liao...&Minglong Chen.(2020).Higher Incidence of Asymptomatic Cerebral Emboli After Atrial Fibrillation Ablation Found With High-Resolution Diffusion-Weighted Magnetic Resonance Imaging.CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY,13,(1)
MLA:
Yaya Yu,et al."Higher Incidence of Asymptomatic Cerebral Emboli After Atrial Fibrillation Ablation Found With High-Resolution Diffusion-Weighted Magnetic Resonance Imaging".CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY 13..1(2020)