Recurrent ischemic stroke in patients with atrial fibrillation ablation and prior stroke: A study based on etiological classification.

Autor: Fukamizu, Seiji, Hojo, Rintaro, Kitamura, Takeshi, Kawamura, Iwanari, Miyazawa, Satoshi, Karashima, Jun, Nakamura, Shin, Takeda, Kosuke, Yamaoka, Koichiro, Arai, Tomoyuki, Kawajiri, Kohei, Tanabe, Sho, Koyano, Yasuki, Miyahara, Daisuke, Tokioka, Sayuri, Arai, Marina, Inagaki, Dai, Miyabe, Tomonori, Sakurada, Harumizu, Hiraoka, Masayasu
Zdroj: Journal of Arrhythmia; Feb2020, Vol. 36 Issue 1, p95-104, 10p
Abstrakt: Background: Different subtypes of ischemic stroke may have different risk factors, clinical features, and prognoses. This study investigated the incidence and mode of stroke recurrence in patients with a history of stroke who underwent atrial fibrillation (AF) ablation. Methods: Of 825 patients who underwent AF ablation from 2006 to 2016, 77 patients (9.3%, median age 69 years) with a prior ischemic stroke were identified. Patients were classified as those with prior cardioembolic (CE) stroke (n = 55) and those with prior non‐CE stroke (n = 22). The incidence and pattern of stroke recurrence were investigated. Results: The incidence of asymptomatic AF (54.5% vs 22.7%; P =.011) and left atrial volume (135.8 mL vs 109.3 mL; P =.024) was greater in the CE group than in the non‐CE group. Anticoagulation treatment was discontinued at an average of 28.1 months following the initial ablation in 34 (44.2%) patients. None of the patients developed CE stroke during a median 4.1‐year follow‐up. In the non‐CE group, 2 patients experienced recurrent non‐CE stroke (lacunar infarction in 1 and atherosclerotic stroke in 1); however, AF was not observed at the onset of recurrent ischemic stroke. Conclusions: In patients with a history of stroke who underwent catheter ablation for AF, the incidence of recurrent stroke was 0.54/100 patient‐years. The previous stroke in these patients may not have been due to AF in some cases; therefore, a large‐scale prospective study is warranted to identify the appro priate antithrombotic therapy for the prevention of potentially recurrent stroke. We investigated stroke recurrence in patients with a prior stroke who underwent atrial fibrillation ablation. Of 77 patients, none developed cardioembolic (CE) stroke during a median follow‐up period of 4.1 years. Two patients (0.54/100 patient‐years) experienced recurrent non‐CE stroke. Therefore, the optimal antithrombotic therapy should be discussed in future studies. [ABSTRACT FROM AUTHOR]
Databáze: Supplemental Index
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