Asymptomatic pulmonary embolism after ablation

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dc.contributor.authorGüler Babür, Gamze
dc.contributor.authorCan, Mehmet Mustafa
dc.contributor.authorGüler, Ekrem
dc.contributor.authorAkıncı, Tuğba
dc.contributor.authorSoğukpınar, Özlem
dc.contributor.authorHatipoğlu, Suzan
dc.contributor.authorKılıçaslan, Fethi
dc.contributor.authorSerebruany, Victor L.
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:50:59Z
dc.date.available10.07.201910:49:13
dc.date.available2019-07-10T19:50:59Z
dc.date.issued2016
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalı
dc.descriptionWOS: 000378791000010
dc.descriptionPubMed ID: 27144590
dc.description.abstractBackground: Pulmonary embolism (PE) is a life-threatening event with a broad presentation spectrum ranging from asymptomatic cases to sudden cardiac arrest. It is unclear if right atrial emboli cause PE in patients with atrial fibrillation (AF) or if mild PE itself increases right cardiac pressure provoking AF. Objective: To determine the incidence and predictors of asymptomatic PE in patients undergoing AF ablation. Method and Results: Patients (n = 93) were screened and those with previous or current symptomatic PE or venous thromboembolism, pulmonary hypertension, increased right heart pressures detected on echocardiography, a history of stroke, transient ischemic attack, coagulopathy or cancer and inappropriate contrast for the evaluation of pulmonary arterial tree were excluded. The remaining AF patients (n = 71) underwent guided ablation controlled with 3-dimensional, left atrial and pulmonary venous computed tomography. The asymptomatic PE was defined by using the modified Miller score by 2 independent assessors in 6 patients. Univariate logistic regression showed that age (OR: 1.094, 95% CI 1.007-1.188, p = 0.033), diabetes (OR: 12.000, 95% CI 1.902-75.716, p = 0.008), CHA(2)DS(2)-VASc score (OR: 2.800, 95% CI 1.304-6.013, p = 0.008), and pulmonary artery diameter (OR: 1.221, 95% CI 1.033-1.444, p = 0.019) were significantly associated with PE. However, multivariate analysis revealed that the CHA(2)DS(2)-VASc score (p = 0.047) remained the exclusive significant predictor for asymptomatic PE. Conclusion: The incidence of random asymptomatic PE in AF patients is high (>8%). The CHA(2)DS(2)-VASc score can predict silent PE. Since patients with a high CHA(2)DS(2)-VASc score are already anticoagulated, our results do not change clinical practice but are noteworthy in terms of the cause-effect relationship between AF and PE.
dc.identifier.citationGüler Babür, G., Can, M. M., Güler, E., Akıncı, T., Soğukpınar, Ö., Hatipoğlu, S. ... Serebruany, V. L. (2016). Asymptomatic pulmonary embolism after ablation. Cardiology, 134(4), 426-432. https://dx.doi.org/10.1159/000444440
dc.identifier.doi10.1159/000444440
dc.identifier.endpage432
dc.identifier.issn0008-6312
dc.identifier.issn1421-9751
dc.identifier.issue4
dc.identifier.scopusqualityQ2
dc.identifier.startpage426
dc.identifier.urihttps://dx.doi.org/10.1159/000444440
dc.identifier.urihttps://hdl.handle.net/20.500.12511/2120
dc.identifier.volume134
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherKarger
dc.relation.ispartofCardiologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectAtrial fibrillation
dc.subjectAsymptomatic pulmonary embolism
dc.subjectAblation
dc.subjectCHA(2)DS(2)-VASc score
dc.titleAsymptomatic pulmonary embolism after ablation
dc.typeArticle

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