Pilot Study of Early Catheter Ablation and Neurological Outcomes in Atrial Fibrillation-Related Stroke: RESCUE-STROKE (JCEP May 2025)-Article: Pilot Study of Early Catheter Ablation and Neurological Outcomes in Atrial Fibrillation-Related Stroke: RESCUE-STROKE

Article: Pilot Study of Early Catheter Ablation and Neurological Outcomes in Atrial Fibrillation-Related Stroke: RESCUE-STROKE

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The study titled "Pilot Study of Early Catheter Ablation and Neurological Outcomes in Atrial Fibrillation-Related Stroke (RESCUE-STROKE)" examines the effect of early catheter ablation (CA) on patients with stroke-related atrial fibrillation (AF). The researchers compared neurological outcomes between two groups: patients who received routine care with medications and those who underwent early CA following a stroke with new-onset AF. <br /><br />The study, conducted from 2021 to 2023, included 72 patients, split evenly between both treatment groups. The functional outcomes were measured using the modified Rankin score (mRS), which assesses disability post-stroke. Initial mRS scores were similar at admission and discharge for both groups. However, significant differences emerged at the 6- and 12-month follow-ups, with those undergoing CA showing considerable improvement.<br /><br />Patients undergoing CA achieved rhythm control faster and had higher freedom from AF at 12 months compared to those receiving routine care. They experienced fewer repeat strokes, lower mortality, and reduced hospitalization rates. While there was no significant difference in repeat bleeding or stroke recurrence, patients in the CA group demonstrated fewer adverse cardiovascular events overall.<br /><br />The findings suggest potential benefits of early CA in managing AF-related strokes, though differences in study populations prevent a direct attribution of outcomes solely to early CA. The study highlights the importance of coordinated care post-stroke, as seen in improved outcomes with structured intervention pathways involving CA.<br /><br />Despite its potential implications, this study acknowledges limitations including its small size and retrospective, single-center design, suggesting the results may not be broadly generalizable. Further, more rigorous randomized controlled trials were indicated to validate these findings further. The paper suggests a future study, the "SAVE-STROKE II," to explore these aspects in detail.

Keywords

catheter ablation

atrial fibrillation

neurological outcomes

stroke

RESCUE-STROKE

modified Rankin score

rhythm control

cardiovascular events

SAVE-STROKE II

randomized controlled trials