Relationship between the posterior atrial wall and the esophagus: Esophageal position during atrial fibrillation ablation.
Atrial fibrillation
Atrial wall thickness
Atrioesophageal fistula
Catheter ablation
Esophageal position
Journal
Heart rhythm O2
ISSN: 2666-5018
Titre abrégé: Heart Rhythm O2
Pays: United States
ID NLM: 101768511
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
entrez:
23
6
2022
pubmed:
24
6
2022
medline:
24
6
2022
Statut:
epublish
Résumé
Atrial fibrillation ablation implies a risk of esophageal thermal injury. Esophageal position can be analyzed with imaging techniques, but evidence for esophageal mobility is inconsistent. The purpose of this study was to analyze esophageal position stability from one procedure to another and during a single procedure. Esophageal position was compared in 2 patient groups. First, preprocedural multidetector computerized tomography (MDCT) of first pulmonary vein isolation and redo intervention (redo group) was segmented with ADAS 3D™ to compare the stability of the atrioesophageal isodistance prints. Second, 3 imaging modalities were compared for the same procedure (multimodality group): (1) preprocedural MDCT; (2) intraprocedural fluoroscopy obtained with the transesophageal echocardiographic probe in place with CARTOUNIVU™; and (3) esophageal fast anatomic map (FAM) at the end of the procedure. Esophageal position correlation between different imaging techniques was computed in MATLAB using semiautomatic segmentation analysis. Thirty-five redo patients were analyzed and showed a mean atrioesophageal distance of 1.2 ± 0.6 mm and a correlation between first and redo procedure esophageal fingerprint of 91% ± 5%. Only 3 patients (8%) had a clearly different position. The multi-imaging group was composed of 100 patients. Esophageal position correlation between MDCT and CARTOUNIVU was 82% ± 10%; between MDCT and esophageal FAM was 80% ± 12%; and between esophageal FAM and CARTOUNIVU was 83% ± 15%. There is high stability of esophageal position between procedures and from the beginning to the end of a procedure. Further research is undergoing to test the clinical utility of the esophageal fingerprinted isodistance map to the posterior atrial wall.
Sections du résumé
Background
UNASSIGNED
Atrial fibrillation ablation implies a risk of esophageal thermal injury. Esophageal position can be analyzed with imaging techniques, but evidence for esophageal mobility is inconsistent.
Objectives
UNASSIGNED
The purpose of this study was to analyze esophageal position stability from one procedure to another and during a single procedure.
Methods
UNASSIGNED
Esophageal position was compared in 2 patient groups. First, preprocedural multidetector computerized tomography (MDCT) of first pulmonary vein isolation and redo intervention (redo group) was segmented with ADAS 3D™ to compare the stability of the atrioesophageal isodistance prints. Second, 3 imaging modalities were compared for the same procedure (multimodality group): (1) preprocedural MDCT; (2) intraprocedural fluoroscopy obtained with the transesophageal echocardiographic probe in place with CARTOUNIVU™; and (3) esophageal fast anatomic map (FAM) at the end of the procedure. Esophageal position correlation between different imaging techniques was computed in MATLAB using semiautomatic segmentation analysis.
Results
UNASSIGNED
Thirty-five redo patients were analyzed and showed a mean atrioesophageal distance of 1.2 ± 0.6 mm and a correlation between first and redo procedure esophageal fingerprint of 91% ± 5%. Only 3 patients (8%) had a clearly different position. The multi-imaging group was composed of 100 patients. Esophageal position correlation between MDCT and CARTOUNIVU was 82% ± 10%; between MDCT and esophageal FAM was 80% ± 12%; and between esophageal FAM and CARTOUNIVU was 83% ± 15%.
Conclusion
UNASSIGNED
There is high stability of esophageal position between procedures and from the beginning to the end of a procedure. Further research is undergoing to test the clinical utility of the esophageal fingerprinted isodistance map to the posterior atrial wall.
Identifiants
pubmed: 35734293
doi: 10.1016/j.hroo.2022.02.007
pii: S2666-5018(22)00052-6
pmc: PMC9207737
doi:
Types de publication
Journal Article
Langues
eng
Pagination
252-260Informations de copyright
© 2022 Published by Elsevier Inc. on behalf of Heart Rhythm Society.
Références
Pacing Clin Electrophysiol. 2021 May;44(5):824-834
pubmed: 33742716
J Interv Card Electrophysiol. 2009 Dec;26(3):159-64
pubmed: 19757002
Indian Heart J. 2018 Jan - Feb;70(1):37-44
pubmed: 29455785
J Cardiovasc Electrophysiol. 2008 Apr;19(4):351-5
pubmed: 18081769
Heart Rhythm. 2006 Mar;3(3):317-27
pubmed: 16500305
J Interv Card Electrophysiol. 2021 Nov 10;:
pubmed: 34757547
Circ Arrhythm Electrophysiol. 2015 Jun;8(3):531-6
pubmed: 25772541
Eur Heart J. 2021 Feb 1;42(5):373-498
pubmed: 32860505
Europace. 2020 Oct 1;22(10):1487-1494
pubmed: 32820324
Heart Rhythm. 2021 Jun;18(6):926-934
pubmed: 33561587
Circ Arrhythm Electrophysiol. 2017 Aug;10(8):
pubmed: 28798021
Circulation. 2005 Sep 6;112(10):1400-5
pubmed: 16129790
J Cardiovasc Electrophysiol. 2007 Feb;18(2):157-60
pubmed: 17338764
Heart Vessels. 2013 May;28(3):360-8
pubmed: 22526381
Europace. 2022 Mar 2;24(3):390-399
pubmed: 34480548