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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.
Piringer, Robert; Deneke, Thomas; Foldyna, Borek; Sonne, Kai; Nentwich, Karin; Ene, Elena; Barth, Sebastian; Lüsebrink, Ulrich; Berkovitz, Artur; Halbfass, Philipp.
Afiliação
  • Piringer R; Philipps-University Marburg, Marburg, Germany.
  • Deneke T; Clinic for Invasive Electrophysiology, Heart Center Bad Neustadt, Bad Neustadt a.d. Saale, Germany.
  • Foldyna B; Clinic for Diagnostic and Interventional Radiology, Heart Center Bad Neustadt a.d. Saale, Bad Neustadt a.d. Saale, Germany.
  • Sonne K; Cardiovascular Imaging Research Center, Massachusetts General Hospital - Harvard Medical School, Boston, Massachusetts, USA.
  • Nentwich K; Clinic for Invasive Electrophysiology, Heart Center Bad Neustadt, Bad Neustadt a.d. Saale, Germany.
  • Ene E; Clinic for Invasive Electrophysiology, Heart Center Bad Neustadt, Bad Neustadt a.d. Saale, Germany.
  • Barth S; Clinic for Invasive Electrophysiology, Heart Center Bad Neustadt, Bad Neustadt a.d. Saale, Germany.
  • Lüsebrink U; Clinic for Invasive Electrophysiology, Heart Center Bad Neustadt, Bad Neustadt a.d. Saale, Germany.
  • Berkovitz A; Department of Cardiology and Angiology, Philipps-University Marburg, Marburg, Germany.
  • Halbfass P; Clinic for Invasive Electrophysiology, Heart Center Bad Neustadt, Bad Neustadt a.d. Saale, Germany.
J Cardiovasc Electrophysiol ; 32(3): 695-703, 2021 03.
Article em En | MEDLINE | ID: mdl-33442930
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.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Veias Pulmonares / Fibrilação Atrial / Ablação por Cateter Tipo de estudo: Diagnostic_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male Idioma: En Revista: J Cardiovasc Electrophysiol Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / FISIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Alemanha País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Veias Pulmonares / Fibrilação Atrial / Ablação por Cateter Tipo de estudo: Diagnostic_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male Idioma: En Revista: J Cardiovasc Electrophysiol Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / FISIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Alemanha País de publicação: Estados Unidos