19 February 2019 : Clinical Research
Silent Cerebral Infarcts Following Left-Sided Accessory Pathway Ablation in Wolff-Parkinson-White (WPW) Syndrome: A Preliminary ReportAndrzej Głowniak1ABDEF*, Marzena Janczarek2CD, Adam Tarkowski1BE, Anna Wysocka13BE, Malgorzata Szczerbo-Trojanowska2DE, Andrzej Wysokiński1DE
Med Sci Monit 2019; 25:1336-1341
BACKGROUND: Catheter ablation is a routine procedure in patients with WPW syndrome. Silent cerebral infarcts (SCI) detected in magnetic resonance imaging may be a complication of the ablation procedure, but it is well documented only in atrial fibrillation ablation. Ablation of left-sided accessory pathways (L-AP) has a similar target area, but WPW patients differ from those with atrial fibrillation, due to lower initial risk of cerebral embolic events. The aim of this study was to determine whether the ablation of left-sided accessory pathways carries the risk of SCI.
MATERIAL AND METHODS: Twenty consecutive patients with overt L-AP referred for RF ablation in our center were included in the study. An irrigated ablation catheter was used in 8 patients, and a non-irrigated ablation catheter was used in 12 patients. Diffusion-weighted magnetic resonance imaging was performed pre-procedurally and on the next day after the ablation in all patients.
RESULTS: Ablation procedures were completed without complications and there were no neurological symptoms following the procedure, although in 2 patients (10%), post-procedural diffusion-weighted magnetic resonance revealed new acute silent cerebral infarcts. Both patients with new cerebral lesions were female, and a non-irrigated catheter was used in both cases.
CONCLUSIONS: This is the first study documenting the presence of silent cerebral infarcts after WPW ablation. Further investigations are needed to evaluate the risk of silent cerebral infarcts associated with L-AP ablation.
Keywords: Catheter Ablation, Stroke, Wolff-Parkinson-White Syndrome, Ablation Techniques, Accessory Atrioventricular Bundle, Atrial Fibrillation, Brain Ischemia, cerebral infarction, Diffusion Magnetic Resonance Imaging, Intracranial Embolism, Middle Aged, Pilot Projects, Treatment Outcome
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