18 Oct Atrial Fibrillation: Risks of Renal, Stroke,Thrombotic Events after Ablation

MedicalResearch.com Interview with:
Dr. med. Jelena Kornej
Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany & University of Birmingham Centre for Cardiovascular Sciences, City Hospital,
Birmingham, United Kingdom

MedicalResearch.com: What are the main findings of the study?

Answer: The main finding of our analysis was that thromboembolic events after atrial fibrillation (AF) catheter ablation are rare, but all three stroke risk stratification scores, i.e. CHADS₂, CHA₂DS₂-VASc, and R₂CHADS₂ were associated with thromboembolic risk in anticoagulated population. Furthermore, patients with AF recurrences had increased risk for thromboembolic complications.

MedicalResearch.com: Were any of the findings unexpected?

Answer:  Great part of our findings is in accordance with previously published studies. However, our study is the largest one assessing the incidence and risk factors for thromboembolic complications after AF catheter ablation during mid-term follow-up with a special focus on renal dysfunction and stroke risk stratification scores. Also, for the first time we show that the CHA₂DS₂-VASc had the best predictive value for thromboembolic events in the subgroup with AF recurrences.

MedicalResearch.com: What should clinicians and patients take away from your report?

Answer:  The results of our study demonstrate that all scores are useful in predicting future thromboembolic events after AF catheter ablation. However, we would encourage the GPs and medical personal to use the CHA₂DS₂-VASc since in our large study cohort this score can differentiate those patients in ‘truly-low’ risk strata (CHA₂DS₂-VASc = 0-1). Our results demonstrated a 4.2-fold risk for thromboembolic events in patients with AF recurrence during follow-up. This data should sensitize cardiologists and GP’s for the proper rhythm outcome control after invasive AF procedure.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Answer:  Although we had careful follow up data in a large consecutive series, our study is limited by its registry design. Prospective randomized trials are required to confirm whether the incidence of thromboembolic events is reduced in the catheter ablation-treated patients. Of note, since the rhythm outcomes follow-up were available only in 75% of our study cohort, the proper rhythm outcome control would be necessary to prove our findings regarding association between thromboembolic events incidence in patients with AF recurrences.

Citation:

Renal Dysfunction, Stroke Risk Scores (CHADS2, CHA2DS2-VASc and R2CHADS2) and the Risk of Thromboembolic Events after Catheter Ablation of Atrial Fibrillation: The Leipzig Heart Center AF Ablation Registry
Citation:

Circ Arrhythm Electrophysiol. 2013 Oct 1;6(5):868-874. Epub 2013 Sep 18.

Kornej J, Hindricks G, Kosiuk J, Arya A, Sommer P, Husser D, Rolf S, Richter S, Piorkowski C, Gaspar T, Lip GY, Bollmann A.

Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.

Last Updated on October 18, 2013 by Marie Benz MD FAAD