Esophageal luminal temperature monitoring using a multi-sensor probe lowers the risk of esophageal injury in cryo and radiofrequency catheter ablation for atrial fibrillation.


Journal

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
ISSN: 1572-8595
Titre abrégé: J Interv Card Electrophysiol
Pays: Netherlands
ID NLM: 9708966

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 11 12 2022
accepted: 22 01 2023
medline: 23 10 2023
pubmed: 7 2 2023
entrez: 6 2 2023
Statut: ppublish

Résumé

Esophageal luminal temperature monitoring is a commonly used strategy to reduce esophageal thermal injury in catheter ablation for atrial fibrillation (AFib). We sought to compare the incidence of endoscopically detected esophageal lesions (EDEL) between two commonly used esophageal luminal temperature probes. Consecutive patients undergoing ablation with esophageal luminal temperature monitoring and upper endoscopy within 24 h after ablation were included. Four hundred forty-five patients (64 ± 10 years, 44% female) were included. Esophageal temperature monitoring was done with a single-sensor probe in 213 (48%) and multi-sensor probe in 232 (52%). Cryoballoon (CB) ablation was performed in 118 (27%) and radiofrequency (RF) ablation in 327 (73%) of patients. EDEL was present in 94 (22.9%) of which 85 were mild, 8 were moderate, and 1 was severe, and none progressed to atrial-esophageal fistula. The use of the multi-sensor probe during CB ablation was associated with a reduction in EDEL compared to single sensor (6.8% vs 24.3%; P = 0.016). Similarly, in the RF ablation group, EDEL was present in 19.5% of the multi-sensor group vs 32.8% in the single-sensor group (P = 0.001). Logistic regression showed that multi-sensor probe use was associated with reduction in EDEL with an odds ratio of 0.23 in CB ablation (P = 0.024) and 0.44 for RF ablation (P = 0.001). Esophageal luminal temperature monitoring during AFib ablation using a multi-sensor probe was associated with a significant reduction in EDEL compared to a single-sensor probe.

Sections du résumé

BACKGROUND BACKGROUND
Esophageal luminal temperature monitoring is a commonly used strategy to reduce esophageal thermal injury in catheter ablation for atrial fibrillation (AFib).
OBJECTIVES OBJECTIVE
We sought to compare the incidence of endoscopically detected esophageal lesions (EDEL) between two commonly used esophageal luminal temperature probes.
METHODS METHODS
Consecutive patients undergoing ablation with esophageal luminal temperature monitoring and upper endoscopy within 24 h after ablation were included.
RESULTS RESULTS
Four hundred forty-five patients (64 ± 10 years, 44% female) were included. Esophageal temperature monitoring was done with a single-sensor probe in 213 (48%) and multi-sensor probe in 232 (52%). Cryoballoon (CB) ablation was performed in 118 (27%) and radiofrequency (RF) ablation in 327 (73%) of patients. EDEL was present in 94 (22.9%) of which 85 were mild, 8 were moderate, and 1 was severe, and none progressed to atrial-esophageal fistula. The use of the multi-sensor probe during CB ablation was associated with a reduction in EDEL compared to single sensor (6.8% vs 24.3%; P = 0.016). Similarly, in the RF ablation group, EDEL was present in 19.5% of the multi-sensor group vs 32.8% in the single-sensor group (P = 0.001). Logistic regression showed that multi-sensor probe use was associated with reduction in EDEL with an odds ratio of 0.23 in CB ablation (P = 0.024) and 0.44 for RF ablation (P = 0.001).
CONCLUSIONS CONCLUSIONS
Esophageal luminal temperature monitoring during AFib ablation using a multi-sensor probe was associated with a significant reduction in EDEL compared to a single-sensor probe.

Identifiants

pubmed: 36745324
doi: 10.1007/s10840-023-01492-1
pii: 10.1007/s10840-023-01492-1
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1827-1835

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Références

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Auteurs

Nashwa M Abdulsalam (NM)

Division of Cardiology, PeaceHealth Southwest Medical Center, 400 NE Mother Jospeh PI, WA, 98664, Vancouver, USA. nashwaabdulsalam@gmail.com.

Arun M Sridhar (AM)

Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA.

Deanna M Tregoning (DM)

Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA.

Beixin J He (BJ)

Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA.

Mahbod Jafarvand (M)

Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA.

Avin Mehri (A)

Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA.

Tanzina Afroze (T)

Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA.

Yaacoub Chahine (Y)

Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA.

Cynthia W Ko (CW)

Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA.

Nazem Akoum (N)

Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA.

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