Dew, thus far to my knowlege even if normal rhythm is reestablished with catheter based procedures, there is no firm data to suggest that the risk of stroke changes. As curious as this is, suggested explainations have been that perhaps patients continue to have unrecognized periods of asymptomatic atrial fib or the atrial tissue substrate is abnormal enough with other factors such as intrinsic inflammatory cytokines playing a role, that the risk of thromboemboli persists. In patients who have had successful conversion to normal rhythm (by drugs or procedures)higher risk patients (those with comorbid conditions like CHF, hypertension, age >75, diabetes, prior stroke or tia's) are still kept on coumadin. Whether devices like the "Watchman" left atrial appendage occluder or complete removal of the left atrial appendage at the time of procedures like the surgical mini maze will have a beneficial effect is yet to be determined. Short version: procedures like the arctic circler and related procedures are done to control patient symptoms not (as yet) to prevent strokes. The current study is interesting because it might reduce the time (and perhaps level of expertice) required to achieve pulmonary vein isolation. Regards, bp
