Home > Publications Database > Comparison of Cerebral Micro-Embolization Detected by Transcranial Doppler Examination Between Radiofrequency Ablation and Pulsed Field Ablation for Atrial Fibrillation. > print

001     282600
005     20260105130608.0
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024 7 _ |a 10.1111/jce.70140
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024 7 _ |a 1045-3873
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024 7 _ |a 0736-6108
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024 7 _ |a 0892-1059
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024 7 _ |a 1540-8167
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024 7 _ |a 2374-8338
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024 7 _ |a 2374-8427
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024 7 _ |a 8756-9264
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037 _ _ |a DZNE-2025-01358
041 _ _ |a English
082 _ _ |a 610
100 1 _ |a Schreiber, Tobias
|0 0000-0001-7511-3809
|b 0
245 _ _ |a Comparison of Cerebral Micro-Embolization Detected by Transcranial Doppler Examination Between Radiofrequency Ablation and Pulsed Field Ablation for Atrial Fibrillation.
260 _ _ |a Oxford
|c 2025
|b Wiley-Blackwell
336 7 _ |a article
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336 7 _ |a ARTICLE
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336 7 _ |a Journal Article
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520 _ _ |a Pulsed Field Ablation (PFA) can establish pulmonary vein isolation via irreversible electroporation and is believed to reduce overall complications; however, periprocedural stroke has also been reported after PFA procedures. Assessment of microembolic signals (MES) measured by transcranial doppler (TCD) allows to monitor cerebral embolization during the procedure and to identify higher risk procedural steps. This study was designed to compare the incidence of MES during different procedural steps between two different PFA systems and radiofrequency ablation (RFA).Pulmonary vein isolation was performed either using either high-power short-duration radiofrequency ablation (HPSD RFA), or PFA using a variable loop circular catheter (VLCC) or a circular multielectrode array catheter (CMAC). MES were compared during transseptal puncture, ablation, left atrial mapping, and introduction/retraction of catheters. Neurological examination was performed pre and post ablation for all patients including the National Institutes of Health Stroke Scale (NIHSS). Fifty-six consecutive patients (19 female (34%), average age 70 years) were included: 28 in the HPSD RFA group and 14 patients each in the VLCC and CMAC groups. Total MES count was higher for both PFA systems compared to HPSD RFA (VLCC 1402 (IQR 973), CMAC 449 (IQR 193) vs. HPSD RFA 131 (IQR 250); p < 0.001). MES count was higher in VLCC than in CMAC (p < 0.001). In all groups, MES were most frequently detected during ablation (87% of overall MES). Postprocedural NIHSS did not differ between groups (median NIHSS 0 [IQR 0] in all groups), yet two patients experienced new focal neurological deficits after PFA.Pulsed field ablation was associated with a higher cerebral MES count than high-power short-duration radiofrequency ablation, with marked differences between catheter systems. Transcranial doppler indicates ablation as the most embolic step in both PFA and high-power short duration ablation.
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650 _ 7 |a atrial fibrillation
|2 Other
650 _ 7 |a microembolism
|2 Other
650 _ 7 |a pulsed field ablation
|2 Other
650 _ 7 |a radiofrequency ablation
|2 Other
650 _ 2 |a Humans
|2 MeSH
650 _ 2 |a Ultrasonography, Doppler, Transcranial
|2 MeSH
650 _ 2 |a Female
|2 MeSH
650 _ 2 |a Atrial Fibrillation: surgery
|2 MeSH
650 _ 2 |a Atrial Fibrillation: diagnosis
|2 MeSH
650 _ 2 |a Atrial Fibrillation: physiopathology
|2 MeSH
650 _ 2 |a Atrial Fibrillation: epidemiology
|2 MeSH
650 _ 2 |a Male
|2 MeSH
650 _ 2 |a Aged
|2 MeSH
650 _ 2 |a Catheter Ablation: adverse effects
|2 MeSH
650 _ 2 |a Catheter Ablation: methods
|2 MeSH
650 _ 2 |a Catheter Ablation: instrumentation
|2 MeSH
650 _ 2 |a Intracranial Embolism: diagnostic imaging
|2 MeSH
650 _ 2 |a Intracranial Embolism: epidemiology
|2 MeSH
650 _ 2 |a Intracranial Embolism: etiology
|2 MeSH
650 _ 2 |a Pulmonary Veins: surgery
|2 MeSH
650 _ 2 |a Pulmonary Veins: physiopathology
|2 MeSH
650 _ 2 |a Middle Aged
|2 MeSH
650 _ 2 |a Treatment Outcome
|2 MeSH
650 _ 2 |a Predictive Value of Tests
|2 MeSH
650 _ 2 |a Time Factors
|2 MeSH
650 _ 2 |a Incidence
|2 MeSH
650 _ 2 |a Risk Factors
|2 MeSH
700 1 _ |a von Rennenberg, Regina
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700 1 _ |a Brämswig, Tim Bastian
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700 1 _ |a Landmesser, Ulf
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700 1 _ |a Hindricks, Gerhard
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700 1 _ |a Nagel, Patrick
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700 1 _ |a Tscholl, Verena
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700 1 _ |a Huemer, Martin
|b 7
700 1 _ |a Lucas, Johannes
|b 8
700 1 _ |a Attanasio, Philipp
|b 9
700 1 _ |a Nolte, Christian H
|b 10
773 _ _ |a 10.1111/jce.70140
|g Vol. 36, no. 12, p. 3288 - 3295
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|t Journal of cardiovascular electrophysiology
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|y 2025
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