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A Prospective Randomized Single‐Center Study on the Risk of Asymptomatic Cerebral Lesions Comparing Irrigated Radiofrequency Current Ablation with the Cryoballoon and the Laser Balloon
Author(s) -
SCHMIDT BORIS,
GUNAWARDENE MELANIE,
KRIEG DETLEF,
BORDIG STEFANO,
FÜRNKRANZ ALEXANDER,
KULIKOGLU MEHMET,
HERRMANN WILFRIED,
CHUN K.R. JULIAN
Publication year - 2013
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12151
Subject(s) - medicine , ablation , asymptomatic , balloon , radiofrequency ablation , randomized controlled trial , single center , cardiology , radiology
Asymptomatic Cerebral Lesions in AF Ablation Background Asymptomatic cerebral lesions (ACL) may occur during atrial fibrillation (AF) ablation. We sought to compare the ACL incidence between 3 contemporary technologies: (1) irrigated radiofrequency current (RFC), (2) the single big cryoballoon (CB), and (3) the endoscopic laser‐balloon (LB) in a prospective randomized pilot study. Methods and Results Ninety‐nine patients were treated in 3 groups. Diffusion weighted MRI was acquired pre‐ (n = 20) and 24–48 h postablation (n = 99). After ablation, new ACL were detected in 22% of patients without significant differences between groups (RFC 8/33; CB 6/33; LB 8/33; P = 0.8). The presence of hypertension was identified as the only independent predictor of ACL by univariate regression analysis. During LB ablation, more ablation lesions (140 ± 19 vs 119 ± 18; P = 0.007) were applied during longer procedures (166 ± 36 vs 143 ± 32 min; P = 0.05) in patients with ACL. Univariate analysis revealed that a higher number of ablation lesions predicted ACL (P = 0.02). Conclusion In this prospective, randomized, single‐center pilot study, ablation technology did not influence the occurrence of ACL during AF ablation.