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Atrial septal defects (ASD), including patent foramen ovale, have been linked to an increased prevalence of migraine headaches in the general population. A similar association with migraine is speculated for iatrogenic ASD due to atrial septal puncture during catheter ablation for atrial fibrillation (AF).
A total of 2,069 patients who underwent catheter ablation for AF at Mayo Clinic, Rochester, MN between January 2001 and December 2008 were scheduled for follow-up at least at 3 months and annually thereafter. Data were collected from the questionnaires patients answered at follow-up inquiring about presence and characteristics of any headaches following the procedure and further chart review. Definite migraine was diagnosed based on clinical features per the International Classification of Headache Disorder-II definition.
Twenty-two patients (1.1%) had a new-onset definite migraine, 12 (0.6%) had a new-onset probable migraine, ten (0.5%) with a previous history of migraine had worsened headaches, and four (0.2%) had headache due to an alternate identifiable cause; a total of 48 patients (2.3%) reported post-procedural headaches. Nineteen of 22 patients (86%) with definite migraine had complete resolution of symptoms at 1- to 2-year follow-up.
New-onset migraine is an uncommon and usually temporary side effect of catheter ablation for AF. The mechanism for post-procedure headache remains unclear.
Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN, 55905, USA.
This article was published in the following journal.
Name: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
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Rapid, irregular atrial contractions caused by a block of electrical impulse conduction in the right atrium and a reentrant wave front traveling up the inter-atrial septum and down the right atrial free wall or vice versa. Unlike ATRIAL FIBRILLATION which is caused by abnormal impulse generation, typical atrial flutter is caused by abnormal impulse conduction. As in atrial fibrillation, patients with atrial flutter cannot effectively pump blood into the lower chambers of the heart (HEART VENTRICLES).
Long-term changes in the electrophysiological parameters and/or anatomical structures of the HEART ATRIA that result from prolonged changes in atrial rate, often associated with ATRIAL FIBRILLATION or long periods of intense EXERCISE.
A class of disabling primary headache disorders, characterized by recurrent unilateral pulsatile headaches. The two major subtypes are common migraine (without aura) and classic migraine (with aura or neurological symptoms). (International Classification of Headache Disorders, 2nd ed. Cephalalgia 2004: suppl 1)
A cardiotonic glycoside obtained mainly from Digitalis lanata; it consists of three sugars and the aglycone DIGOXIGENIN. Digoxin has positive inotropic and negative chronotropic activity. It is used to control ventricular rate in ATRIAL FIBRILLATION and in the management of congestive heart failure with atrial fibrillation. Its use in congestive heart failure and sinus rhythm is less certain. The margin between toxic and therapeutic doses is small. (From Martindale, The Extra Pharmacopoeia, 30th ed, p666)
The pressure within the CARDIAC ATRIUM. It can be measured directly by using a pressure catheter (see HEART CATHETERIZATION). It can be also estimated using various imaging techniques or other pressure readings such as PULMONARY CAPILLARY WEDGE PRESSURE (an estimate of left atrial pressure) and CENTRAL VENOUS PRESSURE (an estimate of right atrial pressure).
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