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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Brain Emboli After Left Ventricular Endocardial Ablation.

Isaac R Whitman1, Rachel A Gladstone1, Nitish Badhwar1

  • 1From Electrophysiology Section, Division of Cardiology, University of California, San Francisco (I.R.W., R.A.G., N.B., H.H.H., B.K.L., E.P.G., G.M.M.); Department of Neurology, University of California, San Francisco (S.A.J., K.M.M., W.P.D., C.P.H.); and Division of Neuroradiology, Department of Radiology, University of California, San Francisco (W.P.D., C.P.H.).

Circulation
|January 26, 2017
PubMed
Summary
This summary is machine-generated.

Left ventricular ablation for ventricular tachycardia and premature ventricular complexes (PVCs) is linked to a high risk of cerebral emboli. Further research is needed to understand and prevent these post-ablation brain lesions.

Keywords:
cardiac complexes, prematurecatheter ablationembolismmagnetic resonance imagingtachycardia, ventricular

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Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Catheter ablation is a common treatment for ventricular tachycardia and premature ventricular complexes (PVCs).
  • Cerebral emboli are a known risk in atrial fibrillation ablation but not well-studied in ventricular ablation.
  • Understanding embolic risk in ventricular ablation is crucial for patient safety.

Purpose of the Study:

  • To evaluate the incidence of cerebral emboli following catheter ablation for ventricular tachycardia and PVCs.
  • To compare embolic risk between left ventricular (LV) and right ventricular ablation procedures.
  • To identify potential risk factors for cerebral emboli in ventricular ablation.

Main Methods:

  • 18 consecutive patients undergoing ventricular ablation were enrolled.
  • Patients were divided into left ventricular (LV) ablation and right ventricular ablation groups.
  • Pre- and postprocedural brain MRI was used to detect embolic infarcts.

Main Results:

  • 58% of patients undergoing LV ablation experienced cerebral emboli (16 total).
  • No cerebral emboli were observed in patients undergoing right ventricular ablation (P=0.04).
  • 63% of patients with a retrograde LV approach developed new brain lesions.

Conclusions:

  • Routine left ventricular ablation procedures are associated with a high incidence of new brain emboli.
  • The findings highlight the need for further research into the long-term effects and prevention strategies for these lesions.
  • Cerebral embolic risk appears significantly lower in right ventricular ablation compared to left ventricular ablation.