Incidence of silent cerebral embolisms after radiofrequency ablation of atrial fibrillation using Thermocool SmartTouch Surround Flow catheter

Abstract Background and Aims This study aimed to investigate the incidence of silent cerebral embolisms (SCEs) after catheter ablation of atrial fibrillation (AF) using the ThermoCool SmartTouch Surround Flow (STSF) catheter compared to the ThermoCool SmartTouch (ST) catheter. Methods This study prospectively enrolled patients who underwent de novo AF ablation using either STSF or ST catheter from December 2022 to February 2024. Cerebral magnetic resonance imagings (MRI) were performed within 24 to 48 h after the procedure to detect the new-onset SCEs. The incidences of SCEs, along with the clinical and procedural data, were compared between the patients using STSF catheter and ST catheter. Risk factors associated with SCEs were analyzed by logistic regression. Results In this study involving 163 patients, AF ablation was conducted using a STSF catheter in 50 patients (the STSF group) and a ST catheter in the remaining 113 patients (the ST group). No significant differences were observed in baseline clinical and demographic characteristics between the two groups. There were no apparent differences in the procedural data between the two groups. The incidence of SCEs was significantly lower in the STSF group compared to the ST group (16% vs. 33.6%, P = 0.021). Multivariate logistic regression analysis indicated that the left ventricular ejection fraction and the use of STSF catheter were independently associated with SCEs after AF ablation. Conclusion Using STSF catheters instead of ST catheters may be associated with reduced incidence of SCE following AF ablation.