Citations 3
Stroke and systemic embolism following atrial fibrillation ablation: the EMBOL-AF Global Registry
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F. , Stiles, Martin K. , García‐Izquierdo, Eusebio, Ares, Gerardo Ruiz , Aguinaga, Luis, Munawar, Dian Andina , Puvrez, Alexis , Gölly, Katharina Ingrid , Rocca, Domenico G. Della , Begić, Edin , d'Avila, Andre, Guimaraes, Henrique, Saad, Eduardo , Dzhinsov, Krasimir R. , TRAYKOV, VASSIL BORISLAVOV , Paredes, Felix Ayala , Glover, Benedict , Macle, Laurent , Khaykin, Yaariv , Pérez-Silva, Armando , Díaz, Juan Carlos , Giraldo-Ramírez, Santiago, Morales, Luis C. 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European Heart Journal | March 31, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Abstract Background and Aims Stroke and systemic embolism are recognized but poorly characterized complications of atrial fibrillation (AF) and left atrial flutter (AFL) catheter ablation. Their incidence, outcomes, and procedural associations remain insufficiently defined. Methods Retrospective global registry was initiated by the European Heart Rhythm Association Scientific Committee. A secure database captured data from ablation centres worldwide on general AF and left AFL ablation activity, as well as detailed information on patients with symptomatic embolic events between 2017 and 2024. Results Overall, 204 centres reported 335 743 ablation procedures and 550 embolic events (incidence 0.16%). Centre-level rate ranged from 0% to 3.1%. Most events were cerebral (94%), followed by peripheral (5%), and combined (1%). Coronary air embolism accounted for 62% of all peripheral events. Intraprocedural events occurred in 93 patients (17%), within 72 h in 357 (78%) and beyond 72 h in 100 (22%); 128 cases (23%) were diagnosed after hospital discharge. Nonparoxysmal AF (0.23% vs 0.15%; P < .001), centre experience, and ablation energy source (radiofrequency, 0.16%; cryoballoon, 0.16%; pulsed field ablation, 0.25%; laserballoon, 0.88%; P < .001) were associated with embolic risk. Median NIHSS score after stroke was 4 (interquartile range, 2–9). Three-month follow-up was available for 518 patients with embolism (95%): 181 (35%) had sequelae and 16 (3%) died. Conclusions Symptomatic embolic events are infrequent but associated with significant morbidity and mortality. Most events occur early, though a substantial proportion arise later. Higher event rates were observed with laser and possibly with pulsed field ablation. A greater centre experience was associated with a lower embolism incidence.
2023 HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Practical Management of the Remote Device Clinic
Ferrick, Aileen M., Kojodjojo, Pipin , López-Cabanillas, Néstor , Chew, Derek S. , Choi, Jong‐Il , Dagres, Nikolaos , Dalal, Aarti , Dechert, Brynn E. , Frazier‐Mills, Camille, Gilbert, Olivia , Hewit, Sherri, Kneeland, Christine , Mirza, Starr DeEllen, Runté, Mary, Sinclair, Susan, Teixeira, Ricardo Alkmim , Vandenberk, Bert , Davenport, Elizabeth , Freedenberg, Vicki , Glotzer, Taya V. , Ikeda, Takanori , Kramer, Daniel B. , Lin, David , Rojel-Martínez, Ulises, Stühlinger, Markus , Varosy, Paul D. , Dagres, Nikolaos , Raj, Satish R , Deneke, Thomas , Abe, Haruhiko , Bovéda, Serge , Han, Janet K. , Hewit, Sherri, Mittal, Suneet , Ricci, Renato Pietro , Teixeira, Ricardo Alkmim , Vandenberk, Bert , Varma, Niraj , Huang, Jin‐Long
Europace | May 20, 2023 | Volume: 25 | Issue: 5 | Pages: No page available
Abstract Remote monitoring is beneficial for the management of patients with cardiovascular implantable electronic devices by impacting morbidity and mortality. With increasing numbers of patients using remote monitoring, keeping up with higher volume of remote monitoring transmissions creates challenges for device clinic staff. This international multidisciplinary document is intended to guide cardiac electrophysiologists, allied professionals, and hospital administrators in managing remote monitoring clinics. This includes guidance for remote monitoring clinic staffing, appropriate clinic workflows, patient education, and alert management. This expert consensus statement also addresses other topics such as communication of transmission results, use of third-party resources, manufacturer responsibilities, and programming concerns. The goal is to provide evidence-based recommendations impacting all aspects of remote monitoring services. Gaps in current knowledge and guidance for future research directions are also identified.
2023 HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Practical Management of the Remote Device Clinic
Ferrick, Aileen M., Kojodjojo, Pipin , López-Cabanillas, Néstor , Chew, Derek S. , Choi, Jong‐Il , Dagres, Nikolaos , Dalal, Aarti , Dechert, Brynn E. , Frazier‐Mills, Camille, Gilbert, Olivia , Hewit, Sherri, Kneeland, Christine , Mirza, Starr DeEllen, Runté, Mary, Sinclair, Susan, Teixeira, Ricardo Alkmim , Vandenberk, Bert , Reviewers, Document, Davenport, Elizabeth , Freedenberg, Vicki , Glotzer, Taya V. , Ikeda, Takanori , Kramer, Daniel B. , Lin, David , Rojel‐Martínez, Ulises, Stühlinger, Markus , Varosy, Paul D. , Huang, Jin-Long, Rojel-Martínez, Ulises, Dagres, Nikolaos , Raj, Satish R , Deneke, Thomas , Abe, Haruhiko , Bovéda, Serge , Han, Janet K. , Mittal, Suneet , Ricci, Renato Pietro , Teixeira, Ricardo Alkmim , Vandenberk, Bert , Varma, Niraj , Reviewers, Document, Huang, Jin‐Long
Journal of Arrhythmia | May 19, 2023 | Volume: 39 | Issue: 3 | Pages: 250-302
AbstractRemote monitoring is beneficial for the management of patients with cardiovascular implantable electronic devices by impacting morbidity and mortality. With increasing numbers of patients using remote monitoring, keeping up with higher volume of remote monitoring transmissions creates challenges for device clinic staff. This international multidisciplinary document is intended to guide cardiac electrophysiologists, allied professionals, and hospital administrators in managing remote monitoring clinics. This includes guidance for remote monitoring clinic staffing, appropriate clinic workflows, patient education, and alert management. This expert consensus statement also addresses other topics such as communication of transmission results, use of third‐party resources, manufacturer responsibilities, and programming concerns. The goal is to provide evidence‐based recommendations impacting all aspects of remote monitoring services. Gaps in current knowledge and guidance for future research directions are also identified.