Risk Factors for Ischemic Stroke in Atrial Fibrillation Patients Undergoing Radiofrequency Catheter Ablation
- Authors
- Kim, Yun Gi; Shim, Jaemin; Oh, Suk-Kyu; Lee, Kwang-No; Choi, Jong-Il; Kim, Young-Hoon
- Issue Date
- 7-May-2019
- Publisher
- NATURE PUBLISHING GROUP
- Citation
- SCIENTIFIC REPORTS, v.9, no.1
- Indexed
- SCI
SCIE
SCOPUS
- Journal Title
- SCIENTIFIC REPORTS
- Volume
- 9
- Number
- 1
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/2035
- DOI
- 10.1038/s41598-019-43566-z
- ISSN
- 2045-2322
- Abstract
- Ischemic stroke after radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) patients is a great challenge for electrophysiologists. We performed this retrospective study to evaluate clinical and echocardiographic characteristics associated with increased risk of ischemic stroke following RFCA. A total of 2,352 consecutive patients with AF who underwent first-time RFCA were analyzed. Among 10,023 patient* year follow up, ischemic stroke occurred in 49 patients (0.49% per year). Late recurrence after last RFCA was significantly associated with ischemic stroke (3.8% vs. 12.9%, p < 0.001). Old age (>= 60 years old) (3.2% vs. 15.4%, p = 0.001), non-paroxysmal AF (hazard ratio = 1.91, p = 0.024), left atrium (LA) size >= 45.0 mm (6.6% vs. 11.7%, p < 0.001), E over E' >= 10 (4.3% vs. 20.1%, p < 0.001), dense spontaneous echo contrast (SEC) (5.2% vs. 19.0%, p = 0.006), and decreased left atrial appendage (LAA) flow velocity (<= 40 cm/sec) (4.1% vs. 10.8%, p < 0.001) were also associated with increased risk of ischemic stroke. The REVEEAL score derived from the risk factors identified in this study was superior to CHA2DS2-VASc score (p < 0.001) for the prediction of ischemic stroke. In conclusion, the risk factors for ischemic stroke in post-RFCA AF patients are not identical to RFCA naive AF patients and different approach to stratify the risk of ischemic stroke is needed.
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Collections - 2. Clinical Science > Department of Cardiology > 1. Journal Articles
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