TY - JOUR
T1 - Characteristics, treatment, and outcomes of periprocedural cerebrovascular accidents during electrophysiologic procedures
AU - Harb, Serge C.
AU - Thomas, George
AU - Saliba, Walid I.
AU - Nakhoul, Georges N.
AU - Hussein, Ayman A.
AU - Duarte, Valeria E.
AU - Bhargava, Mandeep
AU - Baranowski, Bryan
AU - Tchou, Patrick
AU - Dresing, Thomas
AU - Callahan, Thomas
AU - Kanj, Mohamed
AU - Natale, Andrea
AU - Lindsay, Bruce D.
AU - Wazni, Oussama M.
PY - 2013/6
Y1 - 2013/6
N2 - Objectives: We sought to identify the characteristics, treatment, and outcomes of periprocedural cerebrovascular accident (PCVA) during electrophysiologic (EP) procedures. Background: Periprocedural cerebrovascular accident is one of the most feared complications during EP procedures with very few data regarding its characteristics, management, and outcomes. Methods: Between January 1998 and December 2008, we reviewed 30,032 invasive EP procedures for PCVA occurrence and characteristics. Management and outcomes were also determined. Results: Thirty-eight CVAs were identified. Twenty (53 %) were intraprocedural and 18 (47 %) postprocedural. Thirty-two (84 %) were classified as strokes and six (16 %) as transient ischemic attacks. All CVAs except one (37, 97 %) were ischemic and the vast majority occurred during ablation procedures (36, 95 %). Among the 31 patients with ischemic stroke, 11 (35 %) were treated with reperfusion (eight catheter-based therapy and three intravenous t-PA) of whom five (46 %) had complete recovery, three (27 %) had partial recovery, and three (27 %) had no recovery. No hemorrhagic transformations occurred. Conclusion: Periprocedural cerebrovascular accident during EP procedures is rare and is almost always ischemic. It occurs more frequently during ablation procedures. Reperfusion therapy is feasible and safe.
AB - Objectives: We sought to identify the characteristics, treatment, and outcomes of periprocedural cerebrovascular accident (PCVA) during electrophysiologic (EP) procedures. Background: Periprocedural cerebrovascular accident is one of the most feared complications during EP procedures with very few data regarding its characteristics, management, and outcomes. Methods: Between January 1998 and December 2008, we reviewed 30,032 invasive EP procedures for PCVA occurrence and characteristics. Management and outcomes were also determined. Results: Thirty-eight CVAs were identified. Twenty (53 %) were intraprocedural and 18 (47 %) postprocedural. Thirty-two (84 %) were classified as strokes and six (16 %) as transient ischemic attacks. All CVAs except one (37, 97 %) were ischemic and the vast majority occurred during ablation procedures (36, 95 %). Among the 31 patients with ischemic stroke, 11 (35 %) were treated with reperfusion (eight catheter-based therapy and three intravenous t-PA) of whom five (46 %) had complete recovery, three (27 %) had partial recovery, and three (27 %) had no recovery. No hemorrhagic transformations occurred. Conclusion: Periprocedural cerebrovascular accident during EP procedures is rare and is almost always ischemic. It occurs more frequently during ablation procedures. Reperfusion therapy is feasible and safe.
KW - Cerebrovascular accidents
KW - Electrophysiologic procedures
KW - Periprocedural
UR - http://www.scopus.com/inward/record.url?scp=84877580204&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877580204&partnerID=8YFLogxK
U2 - 10.1007/s10840-012-9766-2
DO - 10.1007/s10840-012-9766-2
M3 - Article
C2 - 23263895
AN - SCOPUS:84877580204
SN - 1383-875X
VL - 37
SP - 41
EP - 46
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
IS - 1
ER -