Procedure-Related Thromboembolism in Patients Underwent Atrial Fibrillation Ablation by Using an Open Irrigated Ablation Catheter

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Purpose: Cerebral thromboembolism is a serious complication related to the catheter ablation of atrial fibrillation (AF). We investigated the procedural thromboembolism in patients with AF underwent catheter ablation. Methods: A total of consecutive 174 AF patients who underwent ablation by using an open irrigated ablation catheter was included in the present study. During all procedure, activated coagulation time was maintained 300–350 seconds. Brain diffusion-weighted magnetic imaging (DWI) was performed 2 day after the procedure in all subjects. Results: Cerebral thromboembolism was revealed by the DWI in 23.0% (40/174) of patients following the procedure. All patients with thromboembolism were asymptomatic. In univariate analysis, age was significantly higher (59.4±8.9 vs. 54.8±9.6 years, P=0.009), the left atrium was larger (41.6±5.7 vs. 38.7±5.5 mm, P=0.004) and history of AF was longer (8.4±6.8 vs. 5.3±4.3 years, P=0.0008) in patients with the thromboembolism than those without. In multivariate analysis, history of AF was the only independent predictor of procedure related thromboembolism in patients with AF ablation (odds ratio: 1.13, P=0.01). Conclusion: Procedure related silent thromboembolism was observed in a quarter of patients who underwent AF ablation with an open irrigated ablation catheter. The history of AF was an independent predictor of thromboembolism during catheter ablation of AF.