Incidence of ablation-induced esophageal injury associated with high-power short duration temperature-controlled pulmonary vein isolation using a specialized open-irrigated ablation catheter: A retrospective single-center study

被引:14
作者
Piringer, Robert [1 ]
Deneke, Thomas [2 ]
Foldyna, Borek [3 ,4 ]
Sonne, Kai [2 ]
Nentwich, Karin [2 ]
Ene, Elena [2 ]
Barth, Sebastian [2 ]
Lusebrink, Ulrich [5 ]
Berkovitz, Artur [2 ]
Halbfass, Philipp [2 ,5 ]
机构
[1] Philipps Univ Marburg, Marburg, Germany
[2] Heart Ctr Bad Neustadt, Clin Invas Electrophysiol, Von Guttenberg Str 11, D-97616 Bad Neustadt an der Saale, Germany
[3] Heart Ctr Bad Neustadt Saale, Clin Diagnost & Intervent Radiol, Bad Neustadt an der Saale, Germany
[4] Harvard Med Sch, Cardiovasc Imaging Res Ctr, Massachusetts Gen Hosp, Boston, MA 02115 USA
[5] Philipps Univ Marburg, Dept Cardiol & Angiol, Marburg, Germany
关键词
atrial fibrillation; endoscopically detected esophageal lesion; high-power short duration ablation; pulmonary vein isolation; QDOT ablation catheter; SAFETY;
D O I
10.1111/jce.14883
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: To evaluate short-term efficacy and incidence of ablation-induced endoscopically detected esophageal injury in patients undergoing high-power, short-duration (HPSD) pulmonary vein isolation using a novel irrigated radiofrequency ablation catheter and ablation generator setup. Methods and Results: Atrial fibrillation (AF) patients, who underwent AF ablation using an irrigated radiofrequency ablation catheter specifically designed for a HPSD ablation approach (50 W, with a target Ablation Index of 350 at posterior wall), received postablation esophageal endoscopy after ablation. In total 45 consecutive patients (67 +/- 10 years; 58% male; 42% paroxysmal AF) undergoing AF ablation using a specialized ablation catheter (QDOT) were included in the study. Thirty-one of 45 patients (69%) underwent a first-time pulmonary vein isolation (Group 1, 67 +/- 11 years; 55% male; 48% paroxysmal AF). Fourteen patients (31%) underwent a redo AF procedure (Group 2, 66 +/- 8 years; 64% male; 29% paroxysmal AF). Patients undergoing first-time pulmonary vein isolation were included in the final analysis. In these patients an endoscopically detected esophageal lesion (EDEL) was detected in 5 of 31 (16%) patients (erosion n = 2, ulcer n = 3). Mean contact force at posterior wall ablation sites was significantly lower in patients with postprocedural EDEL compared with patients without EDEL (11.9 +/- 0.8 g vs. 15.6 +/- 4.7 g). Conclusion: PVI using a specialized high-power ablation catheter in conjunction with a HPSD ablation approach results in a 16% incidence of EDEL in first AF ablation candidates. Future studies evaluating high-power short duration ablation strategies should include esophageal endoscopy to estimate the risk of clinically relevant esophageal complications.
引用
收藏
页码:695 / 703
页数:9
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