Risk of Stroke and Recurrence After AF Ablation in Patients With an Initial Event-Free Period of 12 Months

Simon Kochhäuser, M.D.; Pouria Alipour, B.Sc.; Tanjah Haig-Carter, B.Sc.; Kathleen Trought, B.Sc.; Philip Hache, B.Sc.; Yaariv Khaykin, M.D.; Zaev Wulffhart, M.D.; Alfredo Pantano, M.D.; Bernice Tsang, M.D.; David Birnie, M.D.; Atul Verma, M.D.

Disclosures

J Cardiovasc Electrophysiol. 2017;28(3):273-279. 

In This Article

Limitations

This is a retrospective, single-center study and the results only apply to the described patient population. Continuous monitoring for AF/AT recurrence was not systematically performed and the assessment of AF/AT recurrence was based on intermittent monitoring and/or patient questioning, possibly resulting in an underdetection of AF/AT recurrence.

Cerebral imaging was not performed on a regular basis but only when suspicious symptoms were reported. This way stroke or TIA with very little symptoms could have been missed during FU.

The decision to discontinue OAC was completely at the discretion of the treating physician and in accordance with the patient. Holter and ECG documentation of arrhythmias were interpreted by the treating physician and were not independently adjudicated. Since the overall number of stroke or TIA was very low, statistical analysis to evaluate predictors of stroke in our patient collective were not feasible, limiting any conclusion about the etiology and possible risk factors of postablation stroke.

Finally, it is understood that there is a selection bias in choosing patients for AF ablation that likely selects out patients with significant frailty who would otherwise be included in a general population of AF patients. This may cause the risk of stroke postablation to seem lower but does not necessarily imply causality between successful ablation and reduction in stroke risk.

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