{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T12:47:23Z","timestamp":1781873243175,"version":"3.54.5"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T00:00:00Z","timestamp":1553472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005035","name":"Biotronik","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005035","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Stroke is one of the most feared complications during catheter ablation of atrial fibrillation (AF). While symptomatic thromboembolic events are rare, magnetic resonance imaging (MRI) may identify asymptomatic (ie, silent) cerebral lesions (SCLs) following pulmonary vein isolation (PVI) procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>The REDUCE\u2010TE Pilot was a prospective multicenter, single\u2010arm observational study investigating the incidence of SCL in patients with symptomatic paroxysmal AF undergoing PVI with a novel gold\u2010tip, externally irrigated ablation catheter. After ablation, cerebral diffusion\u2010weighted MRI and a postablation follow\u2010up were performed at 1 to 3 days after the ablation procedure. A neurocognitive test was done before and after ablation. The primary study endpoint was the occurrence of one or more new SCLs. Secondary study endpoints included neurocognitive status, procedural success rate, and periprocedural complications including symptomatic thromboembolic events. A total of 104 patients were enrolled (69% male, mean age: 61.5\u2009\u00b1\u20099.7 years, mean CHA<jats:sub>2<\/jats:sub>DS\n<jats:sub>2<\/jats:sub>\u2010VASc score: 1.7\u2009\u00b1\u20091.2). Postprocedural MRI examination was performed in 97 patients, and in nine of them (9.3%; 95% CI: 4.3\u201016.9%) a total of 11 SCLs were detected. Univariate analyses did not reveal any significant predictor for new SCLs. Nonsignificant trends were observed for low activated clotting time during ablation and for international normalized ratio value outside the range of 2 to 3 at ablation. There was no evidence of significant deterioration of neurocognitive function after PVI. In four patients, a pericardial tamponade was noted but all patients fully recovered during follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ablation of AF using a novel gold\u2010tip, externally irrigated ablation catheter, resulted in SCLs in approximately one out of 10 patients without a measurable effect on neurocognitive function.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.13902","type":"journal-article","created":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T03:47:50Z","timestamp":1552016870000},"page":"877-885","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Silent cerebral lesions and cognitive function after pulmonary vein isolation with an irrigated gold\u2010tip catheter: REDUCE\u2010TE Pilot study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5347-9906","authenticated-orcid":false,"given":"Boris","family":"Schmidt","sequence":"first","affiliation":[{"name":"Cardioangiologisches Centrum Bethanien Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e1bor","family":"Sz\u00e9plaki","sequence":"additional","affiliation":[{"name":"Semmelweis University Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bela","family":"Merkely","sequence":"additional","affiliation":[{"name":"Semmelweis University Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Kautzner","sequence":"additional","affiliation":[{"name":"IKEM Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"van Driel","sequence":"additional","affiliation":[{"name":"Haga Ziekenhuis Den Haag The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Bourier","sequence":"additional","affiliation":[{"name":"Deutsches Herzzentrum M\u00fcnchen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malte","family":"Kuniss","sequence":"additional","affiliation":[{"name":"Kerckhoff Klinik Bad Nauheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Bulava","sequence":"additional","affiliation":[{"name":"Faculty of Health and Social Sciences Ceske Budejovice Hospital, University of South Bohemia Budejovice Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"N\u00f6lker","sequence":"additional","affiliation":[{"name":"Katharinen Hospital Unna Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muchtiar","family":"Khan","sequence":"additional","affiliation":[{"name":"Onze Lieve Vrouwe Gasthuis Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten","family":"Lewalter","sequence":"additional","affiliation":[{"name":"Peter Osypka Heart Center Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Klein","sequence":"additional","affiliation":[{"name":"Klinikum St Georg Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beate","family":"Wenzel","sequence":"additional","affiliation":[{"name":"Biotronik SE &amp; 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