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ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1559347
Impact of Preprocedural Anticoagulation on the Incidence of Silent Cerebral Embolisms after Catheter Ablation of Atrial Fibrillation in Patients with Low Thromboembolic Risk
Provisionally accepted
Meng Wang 1
Wei Du 1
Ya-Lan Fei 1 Hao Yang 1 Qing-Shan Dong 1 Xian-Jin Li 1 Shi-Jie Li 1
Ru-Xing Wang 2
Bing Han 1*- 1 Department of Cardiology, XuZhou Central Hospital, Xuzhou, Jiangsu Province, China
- 2 Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu Province, China
Objective The aim of this study was to investigate the impact of preprocedural anticoagulation on the incidence of silent cerebral embolisms (SCEs) assessed by magnetic resonance imaging (MRI) after catheter ablation of atrial fibrillation (AF) in patients with low thromboembolic risk.A total of 141 patients with AF who were identified with low thromboembolic risk based on CHA2DS2-VASc score (0 or 1 for males and 1 or 2 for females) were enrolled in this study. According to whether or not oral anticoagulants (OACs) had been administered for more than 3 weeks prior to the procedure, patients were divided into the anticoagulation group (n=49) and the non-anticoagulation group (n=92). Pulmonary veins were isolated by utilizing irrigated-tip ablation catheters under the guidance of the Carto system. A cerebral MRI was performed 24 to 48 hours after ablation to detect any new-onset SCEs. The incidences of SCEs were compared between the two groups. SCEs were detected in 25 (17.7%) patients. The incidence of SCEs was significantly higher in the non-anticoagulation group compared with the anticoagulation group (22/92 [23.9%] vs 3/49 [6.1%], P=0.002).Multivariate logistic regression analysis showed that the preprocedural application of OACs for more than 3 weeks was the only independent protective factor of SCEs after AF ablation.Conclusion AF ablation carried a substantial risk of SCEs even in patients with low thromboembolic risk. Preprocedural anticoagulation for more than 3 weeks can significantly reduce the incidence of SCEs after ablation in AF patients.
Keywords: Atrial Fibrillation, anticoagulation, Catheter Ablation, silent cerebral embolism, low thromboembolic risk
Received: 12 Jan 2025; Accepted: 03 Apr 2025.
Copyright: © 2025 Wang, Du, Fei, Yang, Dong, Li, Li, Wang and Han. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Bing Han, Department of Cardiology, XuZhou Central Hospital, Xuzhou, Jiangsu Province, China
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