Preoperative personalization of atrial fibrillation ablation strategy to prevent esophageal injury: Impact of changes in esophageal position.
atrial fibrillation
catheter ablation
collateral damage
computed tomography
esophagus
Journal
Journal of cardiovascular electrophysiology
ISSN: 1540-8167
Titre abrégé: J Cardiovasc Electrophysiol
Pays: United States
ID NLM: 9010756
Informations de publication
Date de publication:
05 2022
05 2022
Historique:
revised:
12
02
2022
received:
19
01
2022
accepted:
16
02
2022
pubmed:
12
3
2022
medline:
21
4
2022
entrez:
11
3
2022
Statut:
ppublish
Résumé
Due to changes in esophageal position, preoperative assessment of the esophageal location may not mitigate the risk of esophageal injury in catheter ablation for atrial fibrillation (AF). This study aimed to assess esophageal motion and its impact on AF ablation strategies. Ninety-seven AF patients underwent two computed tomography (CT) scans. The area at risk of esophageal injury (AAR) was defined as the left atrial surface ≤3 mm from the esophagus. On CT1, ablation lines were drawn blinded to the esophageal location to create three ablation sets: individual pulmonary vein isolation (PVI), wide antral circumferential ablation (WACA), and WACA with linear ablation (WACA + L). Thereafter, ablation lines for WACA and WACA + L were personalized to avoid the AAR. Rigid registration was performed to align CT1 onto CT2, and the relationship between ablation lines and the AAR on CT2 was analyzed. The esophagus moved by 3.6 [2.7 to 5.5] mm. The AAR on CT2 was 8.6 ± 3.3 cm The personalization of ablation lines based on a preoperative CT reduced ablation to the AAR despite changes in esophageal position.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
908-916Subventions
Organisme : JHRS-EHRA Fellowship
Organisme : FP7 Ideas: European Research Council
Organisme : French National Agency for Research
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022 Wiley Periodicals LLC.
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