A common treatment for irregular heartbeats known as catheter ablation may result in the formation of brain lesions when it is performed on the left side of the heart, according to new research at University of California, San Francisco. Importantly, there also is evidence these lesions may be associated with cognitive decline, meaning they may not be benign.
In a small study, now available online in the American Heart Association journal Circulation, of patients undergoing catheter ablation for common abnormal heartbeats from the lower chamber of the heart (premature ventricular contractions or PVCs), researchers found a significantly higher rate of seemingly asymptomatic brain injury due to embolism among the patients whose therapy occurred on the left ventricle of the heart, which supplies blood to the brain, compared to patients whose therapy was conducted on the right ventricle, which pumps blood to the lungs.
"This study adds to the growing literature describing brain infarctions in patients who receive a variety of interventional cardiology procedures and sets the stage for investigations aimed at mitigating this risk. As neurologists we should be aware of these potential complications when asked to see patients following these procedures or when counseling patients pre-procedure," said study author and ANA Fellow, S. Andrew Josephson, MD, Professor and Senior Executive Vice Chair, UCSF Department of Neurology.
The researchers recommend further study on the impact of these lesions and strategies to avoid them.
As noted in a release published by the university, “The rate of asymptomatic emboli in similar procedures for other types of heart rhythm disturbances tends to be 10-20 percent,” according to study senior author Gregory Marcus, MD, MAS, a UCSF Health cardiologist and director of clinical research in the UCSF Division of Cardiology.
“Our study finding is relevant to a large number of patients undergoing this procedure and hopefully will inspire many studies to understand the meaning of and how to mitigate these lesions,” Marcus said. “This also will become an important consideration as we think about how to optimally help the large number of people out there with PVCs.”