{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:59:36Z","timestamp":1791219576585,"version":"4.1.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2010,10,26]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Radiofrequency left atrial catheter ablation has become a routine procedure for treatment of atrial fibrillation. The aim of this study was to assess with preprocedural and postprocedural cerebral magnetic resonance imaging the thromboembolic risk, either silent or clinically manifest, in the context of atrial fibrillation ablation. The secondary end point was the identification of clinical or procedural parameters that correlate with cerebral embolism.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              A total of 232 consecutive patients with paroxysmal or persistent atrial fibrillation who were candidates for radiofrequency left atrial catheter ablation were included in the study. Pulmonary vein isolation or pulmonary vein isolation plus linear lesions plus atrial defragmentation with the use of irrigated-tip ablation catheters was performed. All of the patients underwent preprocedural and postablation cerebral magnetic resonance imaging. A periprocedural symptomatic cerebrovascular accident occurred in 1 patient (0.4). Postprocedural cerebral magnetic resonance imaging was positive for new embolic lesions in 33 patients (14). No clinical parameters such as age, hypertension, diabetes mellitus, previous history of stroke, type of atrial fibrillation, and preablation antithrombotic treatment showed significant correlation with ischemic cerebral embolism. Procedural parameters such as activated clotting time value and, in particular, electric or pharmacological cardioversion to sinus rhythm correlated with an increased incidence of cerebral embolism. Cardioversion was also associated with an increased risk of 2.75 (95 confidence interval, 1.29 to 5.89;\n              <jats:italic>P<\/jats:italic>\n              =0.009).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Radiofrequency left atrial catheter ablation carries a low risk of symptomatic cerebral ischemia but is associated with a substantial risk of silent cerebral ischemia detected on magnetic resonance imaging. Independent risk factors for cerebral thromboembolism are the level of activated clotting time and, in particular, the electric or pharmacological cardioversion to sinus rhythm during the procedure.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.110.937953","type":"journal-article","created":{"date-parts":[[2010,10,12]],"date-time":"2010-10-12T04:22:19Z","timestamp":1286857339000},"page":"1667-1673","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":319,"title":["Radiofrequency Catheter Ablation of Atrial Fibrillation: A Cause of Silent Thromboembolism?"],"prefix":"10.1161","volume":"122","author":[{"given":"Fiorenzo","family":"Gaita","sequence":"first","affiliation":[{"name":"From the Department of Cardiology, School of Medicine, Cardinal Massaia Hospital, University of Turin, Asti, Italy (F.G., D.C., M.P., M.S., E.T.); Department of Radiology, Cardinal Massaia Hospital, Asti, Italy (F.C., C.B.); Department of Radiology, School of Medicine, San Giovanni Battista Hospital, University of Turin, Turin, Italy (G.G.); Department of Neuroradiology, CTO Hospital, University of Turin, Turin, Italy (M.C.V.); Department of Cardiology, Hospital of Circolo Insubria University,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Caponi","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, School of Medicine, Cardinal Massaia Hospital, University of Turin, Asti, Italy (F.G., D.C., M.P., M.S., E.T.); Department of Radiology, Cardinal Massaia Hospital, Asti, Italy (F.C., C.B.); Department of Radiology, School of Medicine, San Giovanni Battista Hospital, University of Turin, Turin, Italy (G.G.); Department of Neuroradiology, CTO Hospital, University of Turin, Turin, Italy (M.C.V.); Department of Cardiology, Hospital of Circolo Insubria University,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Pianelli","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, School of Medicine, Cardinal Massaia Hospital, University of Turin, Asti, Italy (F.G., D.C., M.P., M.S., E.T.); Department of Radiology, Cardinal Massaia Hospital, Asti, Italy (F.C., C.B.); Department of Radiology, School of Medicine, San Giovanni Battista Hospital, University of Turin, Turin, Italy (G.G.); Department of Neuroradiology, CTO Hospital, University of Turin, Turin, Italy (M.C.V.); Department of Cardiology, Hospital of Circolo Insubria University,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Scaglione","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, School of Medicine, Cardinal Massaia Hospital, University of Turin, Asti, Italy (F.G., D.C., M.P., M.S., E.T.); Department of Radiology, Cardinal Massaia Hospital, Asti, Italy (F.C., C.B.); Department of Radiology, School of Medicine, San Giovanni Battista Hospital, University of Turin, Turin, Italy (G.G.); Department of Neuroradiology, CTO Hospital, University of Turin, Turin, Italy (M.C.V.); Department of Cardiology, Hospital of Circolo Insubria University,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Toso","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, School of Medicine, Cardinal Massaia Hospital, University of Turin, Asti, Italy (F.G., D.C., M.P., M.S., E.T.); Department of Radiology, Cardinal Massaia Hospital, Asti, Italy (F.C., C.B.); Department of Radiology, School of Medicine, San Giovanni Battista Hospital, University of Turin, Turin, Italy (G.G.); Department of Neuroradiology, CTO Hospital, University of Turin, Turin, Italy (M.C.V.); Department of Cardiology, Hospital of Circolo Insubria University,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Cesarani","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, School of Medicine, Cardinal Massaia Hospital, University of Turin, Asti, Italy (F.G., D.C., M.P., M.S., E.T.); Department of Radiology, Cardinal Massaia Hospital, Asti, Italy (F.C., C.B.); Department of Radiology, School of Medicine, San Giovanni Battista Hospital, University of Turin, Turin, Italy (G.G.); Department of Neuroradiology, CTO Hospital, University of Turin, Turin, Italy (M.C.V.); Department of Cardiology, Hospital of Circolo Insubria University,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Boffano","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, School of Medicine, Cardinal Massaia Hospital, University of Turin, Asti, Italy (F.G., D.C., M.P., M.S., E.T.); Department of Radiology, Cardinal Massaia Hospital, Asti, Italy (F.C., C.B.); Department of Radiology, School of Medicine, San Giovanni Battista Hospital, University of Turin, Turin, Italy (G.G.); Department of Neuroradiology, CTO Hospital, University of Turin, Turin, Italy (M.C.V.); Department of Cardiology, Hospital of Circolo Insubria University,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Gandini","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, School of Medicine, Cardinal Massaia Hospital, University of Turin, Asti, Italy (F.G., D.C., M.P., M.S., E.T.); Department of Radiology, Cardinal Massaia Hospital, Asti, Italy (F.C., C.B.); Department of Radiology, School of Medicine, San Giovanni Battista Hospital, University of Turin, Turin, Italy (G.G.); Department of Neuroradiology, CTO Hospital, University of Turin, Turin, Italy (M.C.V.); Department of Cardiology, Hospital of Circolo Insubria University,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Consuelo","family":"Valentini","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, School of Medicine, Cardinal Massaia Hospital, University of Turin, Asti, Italy (F.G., D.C., M.P., M.S., E.T.); Department of Radiology, Cardinal Massaia Hospital, Asti, Italy (F.C., C.B.); Department of Radiology, School of Medicine, San Giovanni Battista Hospital, University of Turin, Turin, Italy (G.G.); Department of Neuroradiology, CTO Hospital, University of Turin, Turin, Italy (M.C.V.); Department of Cardiology, Hospital of Circolo Insubria University,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"De Ponti","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, School of Medicine, Cardinal Massaia Hospital, University of Turin, Asti, Italy (F.G., D.C., M.P., M.S., E.T.); Department of Radiology, Cardinal Massaia Hospital, Asti, Italy (F.C., C.B.); Department of Radiology, School of Medicine, San Giovanni Battista Hospital, University of Turin, Turin, Italy (G.G.); Department of Neuroradiology, CTO Hospital, University of Turin, Turin, Italy (M.C.V.); Department of Cardiology, Hospital of Circolo Insubria University,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franck","family":"Halimi","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, School of Medicine, Cardinal Massaia Hospital, University of Turin, Asti, Italy (F.G., D.C., M.P., M.S., E.T.); Department of Radiology, Cardinal Massaia Hospital, Asti, Italy (F.C., C.B.); Department of Radiology, School of Medicine, San Giovanni Battista Hospital, University of Turin, Turin, Italy (G.G.); Department of Neuroradiology, CTO Hospital, University of Turin, Turin, Italy (M.C.V.); Department of Cardiology, Hospital of Circolo Insubria 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