Citations 4
Stroke and systemic embolism following atrial fibrillation ablation: the EMBOL-AF Global Registry
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Sánchez, Sánchez-Somonte, Paula, Segura, Jose Maria, Segura-Villalobos, Federico, Hernández, Pablo Ruiz, Soria, Laura Valverde , Fengsrud, Espen, Reichlin, Tobias, Krisai, Philipp, Tramèr, Lucas, Ngarmukos, Tachapong , Trines, Serge A., Mulder, Bart A. , İhtisas, Yüksek, Yilancioğlu, Yiğit, Şahin, Durmuş Yıldıray , Yalin, Kivanc, Yalman, Hakan , Aytemir, Kudret, Martin, Claire A , Zeriouh, Sarah , Abbas, Mohamed Magdi, Chamoun, Nadia , Bsoul, Mayana, Mohanty, Sanghamitra, Uzokov, Jamol, Benchetrit, Chamia, Choi, Jong‐Il , Joung, Boyoung , Roten, Laurent , Del-Carpio Munoz, Freddy , Sanders, Prashanthan , Sticherling, Christian , Joung, Boyoung , Wichterle, Dan , Cay, Serkan , Kato, Hiroyuki , Deharo, Jean Claude , Choi, Eue-Keun , Bergau, Leonard , Lellouche, Nicolas , Marijon, Eloi , Ramos Jiménez, Javier , Metzner, Andreas , Pürerfellner, Helmut , Merino, Jose L , Heeger, Christian-Hendrik H. , Veltmann, Christian , Sommer, Philipp , Kistler, Peter M. , Chen, Ming-Long , Munoz, Freddy Del‐Carpio , Albarrán‐Rincón, Ramón , Sanders, Prashanthan , Laredo, Mikael , Guénancia, Charles , Natale, Andrea , Almorad, Alexandre , Ruwald, Martin H , Carnero, Guillermo A. , Deharo, Jean‐Claude , Sadek, Mouhannad M. , Iwasaki, Yu‐ki , Choi, Eue‐Keun , Kojić, Dejan , Sousa, João de , Bergau, Leonard , Inaba, Osamu , Piccini, Jonathan P. , Marijon, Éloi , Sandgaard, Niels C. 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. Sàenz, Đula, Kristijan , Peichl, Petr , Larsen, Jacob Moesgaard , Jacobsen, Peter Karl , Hallon, Luis A., Rivadeneira, José Elizardo Llorente , Botros, Michael, Anselme, Frédéric , Chaumont, Corentin , Bakouboula, Babé , Bovéda, Serge , Richard-Vitton, Robin , Boulé, Stéphane , Fauchier, Laurent , Garcia, Rodrigue , Salaun, Alexandre, Gandjbakhch, Estelle , Martins, Raphaël P. , Maury, Philippe , Beneyto, Maxime M , Piot, Olivier , Ballatore, Andrea , Asbach, Stefan , Avranas, Konstantinos, Didenko, Maxim , Eckardt, Lars , Harloff, Tim , Halbfaß, Philipp , Tilz, Roland Richard , Lian, Evgeny, Sohns, Christian , Lüker, Jakob , Zabel, Markus , Letsas, Κonstantinos P. , Leventopoulos, Georgios , Tzeis, Stylianos , Kupó, Péter , Geller, Laszlo A. , Narasimhan, Calambur, Pandurangi, Ulhas M. , Ghosh, Anindya , Haim, Moti , Konstantino, Yuval , Barletta, Valentina , Cipolletta, Laura , Conti, Sergio , Sgarito, Giuseppe A. , Poggi, Sara , Ruggiero, Donatella , Ejima, Koichiro , Shimizu, Wataru, Kato, Hiroyuki, Abdrakhmanov, Ayan Suleimenovich , Bakytzhanuly, A, Kupics, Kaspars , Jubele, Kristīne , Refaat, Marwan M., Ghazawi, Alaaeddine El , Sammut, Mark Adrian , Rojel-Martínez, Ulises, Bozada-Nolasco, Karla I., Denysiuk, Piotr , Farkowski, Michał M. , Futyma, Piotr , Zarębski, Łukasz , Kiliszek, Marek , Kulakowski, Piotr , Lenarczyk, Radosław , Miśkowiec, Dawid Łukasz , Sousa, Pedro , Grecu, Mihaela, Arenal, Ángel , Cabanas‐Grandío, Pilar , León, Rocío Cózar , Dı́az-Infante, Ernesto , Fernandez-Armenta, Juan, Olea, Alain García, Guasch, Eduard , Ibáñez, José Luis , Garrido, Beatriz Jáuregui, Osca, Joaquín , Rivas‐Gándara, Nuria , Campal, J M Rubio, Sánchez-Somonte, Paula , Segura, José María, Fengsrud, Espen , Bergonti, Marco , Reichlin, Tobias , Krisai, Philipp , Tramèr, Lucas , Trines, Serge A.I.P. , Özkan, Eyüp , Özcan, Emin Evren , Yılancıoğlu, Yiğit, Yalın, Kıvanç , Aytemir, Kudret , Abbas, Mohamed Magdy, Akoum, Nazem , Bsoul, Mayana , Mohanty, Sanghamitra
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.
2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation
Calkins, Hugh , Hindricks, Gerhard , Cappato, Riccardo , Kim, Young‐Hoon , Aguinaga, Luis, Akar, Joseph G. , Badhwar, Vinay , Camm, A. John , Chen, Peng‐Sheng , Chen, Shih‐Ann , Chung, Mina K. , Nielsen, Jens Cosedis , Curtis, Anne B. , Davies, D. Wyn, Groot, Natasja M.S. de , Duytschaever, Mattias , Edgerton, James R. , Ellenbogen, Kenneth A. , Ernst, Sabine , Fenelon, Guilherme , Gerstenfeld, Edward P. , Haines, David E. , Haïssaguerre, Michel , Jackman, Warren M. , Jalife, José , Kalman, Jonathan M. , Kautzner, Josef , Kottkamp, Hans , Kuck, Karl Heinz, Kumagai, Koichiro , Lee, Richard, Lewalter, Thorsten , Lindsay, Bruce D., Mansour, Moussa , Michaud, Gregory F., Nakagawa, Hiroshi , Natale, Andrea , Okumura, Ken , Packer, Douglas L. , Reynolds, Matthew R. , Sanders, Prashanthan , Scanavacca, Maurício , Schilling, Richard J. , Tondo, Claudio , Tsao, Hsuan-Ming, Verma, Atul , Wilber, David J. , Reviewers:, Document, Paola, Ângelo Amato Vincenzo de , Kistler, Peter M. , Pisani, Cristiano , Raviele, Antonio , Satomi, Kazuhiro , Stiles, Martin K. , Willems, Stephan , Haı̈ssaguerre, Michel , Packer, Douglas, Verma, Atul , Natale, Andrea , Sanders, Prashanthan , Nielsen, Jens C , de Groot, Natasja M S , Saad, Eduardo , Brugada, Josép , Day, John , d'Avila, Andre , Biase, Luigi Di , Ellinor, Patrick T. , Haissaguerre, Michel , Helm, Robert H. , Hylek, Elaine M. , Macle, Laurent , Marchlinski, Francis E. , Michaud, Gregory F. , Nattel, Stanley , Pokushalov, Evgeny A. , Tsao, Hsuan-Ming, Yamane, Teiichi , Reviewers:, Document, Blomström‐Lundqvist, Carina , Lip, Gregory Y H , Peters, Nicholas Simon , Scanavacca, Maurício , Tondo, Claudio , Ernst, Sabine , Ellenbogen, Kenneth A
EP Europace | January 17, 2018 | Volume: 20 | Issue: 1 | Pages: e1-e160
2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary
Calkins, Hugh , Hindricks, Gerhard , Cappato, Riccardo , Kim, Young‐Hoon , Aguinaga, Luis, Akar, Joseph G. , Badhwar, Vinay , Camm, A. John , Chen, Peng‐Sheng , Chen, Shih‐Ann , Chung, Mina K. , Nielsen, Jens Cosedis , Curtis, Anne B. , Davies, D. Wyn, Groot, Natasja M.S. de , Duytschaever, Mattias , Edgerton, James R. , Ellenbogen, Kenneth A. , Ernst, Sabine , Fenelon, Guilherme , Gerstenfeld, Edward P. , Haines, David E. , Haïssaguerre, Michel , Jackman, Warren M. , Jalife, José , Kalman, Jonathan M. , Kautzner, Josef , Kottkamp, Hans , Kuck, Karl Heinz, Kumagai, Koichiro , Lee, Richard, Lewalter, Thorsten , Lindsay, Bruce D., Mansour, Moussa , Michaud, Gregory F., Nakagawa, Hiroshi , Natale, Andrea , Okumura, Ken , Packer, Douglas L. , Reynolds, Matthew R. , Sanders, Prashanthan , Scanavacca, Maurício , Schilling, Richard J. , Tondo, Claudio , Tsao, Hsuan-Ming, Verma, Atul , Wilber, David J. , Haı̈ssaguerre, Michel , Packer, Douglas, Verma, Atul , Natale, Andrea , Sanders, Prashanthan , Nielsen, Jens C , de Groot, Natasja M S , Saad, Eduardo , Brugada, Josép , Day, John , d'Avila, Andre , Biase, Luigi Di , Ellinor, Patrick T. , Haissaguerre, Michel , Helm, Robert H. , Hylek, Elaine M. , Macle, Laurent , Marchlinski, Francis E. , Michaud, Gregory F. , Nattel, Stanley , Pokushalov, Evgeny A. , Tsao, Hsuan-Ming, Yamane, Teiichi , Scanavacca, Maurício , Tondo, Claudio , Ernst, Sabine , Ellenbogen, Kenneth A
EP Europace | January 5, 2018 | Volume: 20 | Issue: 1 | Pages: 157-208
Incidence and Significance of Early Recurrences of Atrial Fibrillation After Cryoballoon Ablation
Andrade, Jason G. , Packer, Doug L., Lehmann, John W., Holcomb, Richard , Ruskin, Jeremy N. , Dubuc, Marc, Khairy, Paul , Macle, Laurent , Andrade, Jason G
Circulation: Arrhythmia and Electrophysiology | January 21, 2014 | Volume: 7 | Issue: 1 | Pages: 69-75
Background— Early recurrence of atrial fibrillation (ERAF) is common after radiofrequency catheter ablation for AF. We sought to determine the incidence and prognostic significance of ERAF after cryoballoon ablation. Moreover, the benefit of early reablation for ERAF after cryoballoon ablation is undetermined. Methods and Results— The Sustained Treatment of Paroxysmal Atrial Fibrillation (STOP AF) trial randomized 245 patients with paroxysmal AF to medical therapy versus cryoballoon-based pulmonary vein ablation. Patients were followed for 12 months. ERAF was defined as any recurrence of AF >30 seconds during the first 3 months of follow-up. Late recurrence (LR) was defined as any recurrence of AF >30 seconds between 3 and 12 months. Of the 163 patients randomized to cryoablation, 84 patients experienced ERAF (51.5%). The only significant factor associated with ERAF was male sex (hazard ratio [HR], 2.18; 95% confidence interval [CI], 1.03–4.61; P =0.041). LR was observed in 41 patients (25.1%), and was significantly related to ERAF (55.6% LR with ERAF versus 12.7% without ERAF; P <0.001). Among patients with ERAF, only current tobacco use (HR, 3.84; 95% CI, 1.82–8.11; P <0.001) was associated with LR. Conversely, early reablation was associated with greater freedom from LR (3.3% LR with early reablation versus 55.6% without; HR, 0.04; 95% CI, 0.01–0.32; P =0.002). Conclusions— ERAF after cryoballoon ablation occurs in ≈50% of patients and is strongly associated with LR. Early reablation for ERAF is associated with excellent long-term freedom from recurrent AF.