Predictors of Cerebral Microembolization during Phased Radiofrequency Ablation of Atrial Fibrillation: Role of the Ongoing Rhythm and the Site of Energy Delivery

Edina Nagy-Balo, Alexandra Kiss, Catherine Condie, Mark Stewart, Istvan Edes, Zoltan Csanadi

Research output: Contribution to journalArticle

6 Citations (Scopus)


Background Pulmonary vein isolation with phased radiofrequency current and use of a pulmonary vein ablation catheter (PVAC) has recently been associated with a high incidence of clinically silent brain infarcts on diffusion-weighted magnetic resonance imaging, and a high microembolic signal (MES) count detected by transcranial Doppler. We investigated the potential effects of the ongoing rhythm and the target vein during energy delivery (ED) on MES generation during PVAC ablations. Methods and Results A total of 735 EDs during 48 PVAC ablations were analyzed. MES counts were recorded for each ED and time-stamped for correlation with the ongoing rhythm and the target vein for each ED. Significantly higher MES counts were observed during ablations of the left-sided as compared with the right-sided pulmonary veins (P = 0.0003). Similarly, higher MES counts were detected during EDs in atrial fibrillation as compared with sinus rhythm when the temperature was >56C (P < 0.0001). The ongoing rhythm had no effect on the number of MESs at lower temperatures during ablation. Conclusions Both the ongoing rhythm during ED and the site of ablation influence microembolus generation during PVAC ablation procedures.

Original languageEnglish
Pages (from-to)1436-1441
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Issue number11
Publication statusPublished - Nov 1 2014



  • GENius generator
  • PVAC catheter
  • atrial fibrillation
  • pulmonary vein isolation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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