{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:36:10Z","timestamp":1756308970574,"version":"3.41.2"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,4,3]]},"abstract":"\n Background<\/jats:title>\n \n Incidental mobile thrombi are commonly found on endovascular leads of cardiac implantable electronic devices (\n CIED<\/jats:styled-content>\n s). Transseptal puncture for catheter ablation of arrhythmia poses a risk for paradoxical embolism. We examined risk of ischemic stroke, transient ischemic attack (\n TIA<\/jats:styled-content>\n ), or systemic embolism after transseptal ablation in patients with and without\n CIED<\/jats:styled-content>\n s.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Using a national administrative claims database, 31\u00a0720 patients who underwent a transseptal catheter ablation between January 2004 and September 2014 were identified. Two propensity\u2010matched cohorts were created by matching demographic variables, administrative variables, Charlson Comorbidity Index,\n CHA<\/jats:styled-content>\n 2<\/jats:sub>\n DS<\/jats:styled-content>\n 2<\/jats:sub>\n \u2010Vasc score, and year and indication for ablation (5533 and 11\u00a0300 patients with and without\n CIED<\/jats:styled-content>\n s). Incidence rates and Cox proportional hazards models were used to estimate risk of ischemic stroke,\n TIA<\/jats:styled-content>\n , or systemic embolism for patients with and without\n CIED<\/jats:styled-content>\n s. Impact of oral anticoagulation (\n OAC<\/jats:styled-content>\n ) use on the endpoint was examined. Over a mean follow\u2010up of 2.1\u00a0years, the incidence of the combined endpoint was 1.9 per 100\u00a0person\u2010years in patients with\n CIED<\/jats:styled-content>\n s and 1.5 per 100\u00a0person\u2010years in patients without\n CIED<\/jats:styled-content>\n s (\n P<\/jats:italic>\n =0.03). Among patients not on\n OAC<\/jats:styled-content>\n , presence of a cardiac device was associated with an increased risk (hazard ratio [\n HR<\/jats:styled-content>\n ], 1.71 [1.24\u20132.35];\n P<\/jats:italic>\n <0.01), whereas there was no association noted among patients treated with\n OAC<\/jats:styled-content>\n (\n HR<\/jats:styled-content>\n , 0.98 [0.75\u20131.28]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n CIED<\/jats:styled-content>\n s are associated with an increased risk of stroke,\n TIA<\/jats:styled-content>\n , or systemic embolism after transseptal ablation, but this risk is attenuated with postablation\n OAC<\/jats:styled-content>\n use. Role of anticoagulation post\u2010transseptal ablation in patients with\n CIED<\/jats:styled-content>\n warrants further investigation.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.003163","type":"journal-article","created":{"date-parts":[[2016,4,14]],"date-time":"2016-04-14T05:49:30Z","timestamp":1460612970000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Ischemic Stroke or Systemic Embolism After Transseptal Ablation of Arrhythmias in Patients With Cardiac Implantable Electronic Devices"],"prefix":"10.1161","volume":"5","author":[{"given":"Malini","family":"Madhavan","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoxi","family":"Yao","sequence":"additional","affiliation":[{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN"},{"name":"Division of Health Care Policy and Research, Department of Health Services Research, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsey R.","family":"Sangaralingham","sequence":"additional","affiliation":[{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN"},{"name":"Optum Labs, Cambridge, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel J.","family":"Asirvatham","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul A.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J.","family":"McLeod","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan M.","family":"Sugrue","sequence":"additional","affiliation":[{"name":"Department of Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher V.","family":"DeSimone","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter A.","family":"Noseworthy","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN"},{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euu020"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2006.04.034"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12663"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eup428"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12279"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.01.014"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2006.00519.x"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.028647"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2004.04081.x"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.0038"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(92)90133-8"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq278"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.9143"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.02.020"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000032240.28636.BD"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.10.046"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003540"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.03.022"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.08.013"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2009.04.030"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8183.2011.00630.x"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.81.4.1190"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.10.024"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.110.959015"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.23485"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002597"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.115.003163","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:20:07Z","timestamp":1715595607000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.115.003163"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,4,3]]},"references-count":27,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2016,4,3]]}},"alternative-id":["10.1161\/JAHA.115.003163"],"URL":"https:\/\/doi.org\/10.1161\/jaha.115.003163","relation":{},"ISSN":["2047-9980"],"issn-type":[{"type":"electronic","value":"2047-9980"}],"subject":[],"published":{"date-parts":[[2016,4,3]]},"assertion":[{"value":"2016-01-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-02-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-04-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e003163"}}