Migraine with aura after an uneventful cardiac ablation for paroxysmal atrial fibrillation: case report and review of the literature

Editor’s note: The research described below comes from a recipient of a 2024 MSC Travel Grant supporting travel to the 66th Annual Scientific Meeting of the American Headache Society. These grants reimburse travel expenses for those who have had their abstract for a presentation or poster accepted at a meeting.

By Guy Greco, MD, fellow, University of Miami, US.

What is the research gap that your study addresses?

New onset attacks and triggering of migraine or migraine aura have been reported after cardiac ablation procedures for atrial fibrillation. Migraine resulting from cardiac ablation has not been well described. Headache attributed to this procedure is not specifically recognized.

What is your research hypothesis?

Migraine aura after cardiac ablative procedures is an under-reported phenomenon that requires more research.

What methodology did you use to address your research hypothesis?

This is a case report by chart review of a patient with migraine with aura as a complication of cardiac ablation for paroxysmal atrial fibrillation. We additionally conducted a literature review by searching for key words: “migraine”, “aura”, “atrial fibrillation”, “cardiac ablation”, and “pulmonary vein isolation.”  We found 11 relevant articles, consisting of a total of 35 patients. Descriptive statistics were used including frequencies of migraine subtypes by aura status.

What are the main results of your study?

Migraine with aura is a less common, post-procedural complication of cardiac ablation procedures for paroxysmal atrial fibrillation.

What conclusions did you reach based on your results?

Although this complication of migraine aura after cardiac ablation is likely underreported in the literature, the mechanism remains unclear. More research into this phenomenon is needed to contribute to the understanding of this occurrence, which may be facilitated by inclusion in the ICHD-3.

What are the limitations of your study?

It is a case report, and a review of a limited number of articles.

What is the relevance of your study to migraine?

Recognition of migraine with aura after cardiac ablation as a phenomenon could lead to its ultimate inclusion in the ICHD-3.