Risk Factors for Ischemic Stroke in Atrial Fibrillation Patients Undergoing Radiofrequency Catheter Ablation

Yun Gi Kim, Jaemin Shim, Suk Kyu Oh, Kwang No Lee, Jongil Choi, Young Hoon Kim

Research output: Contribution to journalArticle

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 CHA 2 DS 2 -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.

Original languageEnglish
Article number7051
JournalScientific Reports
Volume9
Issue number1
DOIs
Publication statusPublished - 2019 Dec 1

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Catheter Ablation
Atrial Fibrillation
Stroke
Atrial Appendage
Heart Atria
Retrospective Studies
Recurrence

ASJC Scopus subject areas

  • General

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Risk Factors for Ischemic Stroke in Atrial Fibrillation Patients Undergoing Radiofrequency Catheter Ablation. / Kim, Yun Gi; Shim, Jaemin; Oh, Suk Kyu; Lee, Kwang No; Choi, Jongil; Kim, Young Hoon.

In: Scientific Reports, Vol. 9, No. 1, 7051, 01.12.2019.

Research output: Contribution to journalArticle

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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 CHA 2 DS 2 -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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