03-DİĞER

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https://dspace.ankara.edu.tr/handle/20.500.12575/21977

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Browsing 03-DİĞER by Author "Acıbuca, Aynur"

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    Atriyal fibrilasyon ablasyonu yapılan hastalarda nörolojik sonuçlar ve bu sonuçların nöron spesifik enolaz düzeyleri ile ilişkisi
    (Tıp Fakültesi, 2015) Acıbuca, Aynur; Altın, Ali Timuçin; Tıp
    Catheter ablation of atrial fibrillation (AF) is a favourable therapeutic option for the treatment of patients, who are symptomatic despite antiarrhytmic medication. However, this procedure may lead to thromboembolic complications, especially stroke. Silent cerebral embolism is more frequent than clinically apparent stroke. We aimed to measure periprocedural serum neuron-specific enolase (NSE) levels, which is known as biomarker of neuronal injury. Methods: Forty three patients with paroxysmal AF underwent pulmonary vein isolation performed by radiofrequency ablation. A neurological examination was performed pre- and postprocedural period. Serum NSE levels were determined before and at the end of the procedure, at 2, 24 and 48 hours after the procedure. Results: None of the patients developed new neurological deficits. But NSE levels increased after ablation above the upper reference limit of 17 ng/ml in 14 patients; and also 50% increase was observed compared to baseline in 33 patients. No clinical parameters such as age, hypertension, previous history of stroke, diabetes mellitus, CHA2DS2 VASc score, atherosclerotic heart disease and no procedural parameters such as activated clotting time value, total procedure time, electrical cardioversion were associated with an increased level of NSE. On the other hand, patients with increased NSE levels above the upper reference limit had larger left atrium and patients with 50% increase in NSE level had lower minimum SBP measurement during the procedure. Conclusion: Serial assessment of serum NSE level may help to predict acute brain injury related to AF ablation in a low price and readily available manner. However, further research, in which magnetic resonance imaging or other laboratory methods are used, needed to support biomarker based approach in detecting silent cerebral embolism.