Risk of esophageal thermal injury during catheter ablation for atrial fibrillation guided by different ablation index
- 17 May 2020
- journal article
- research article
- Published by Wiley in Pacing and Clinical Electrophysiology
- Vol. 43 (7), 633-639
- https://doi.org/10.1111/pace.13941
Abstract
Background During ablation for atrial fibrillation (AF), energy delivery towards the left atrial posterior wall may cause esophageal injury (EI). Ablation index (AI) was introduced to estimate ablation lesion size, however, the impact of AI technology on the risk of EI has not been explored. Method From March 2019 to December 2019, 60 patients with paroxysmal AF undergoing first‐time ablation were prospectively enrolled. The first 30 consecutive patients were ablated with the AI target value of 400 (AI‐400 group), and the later 30 consecutive patients were ablated with the AI target value of 350 at the posterior wall (AI‐350 group).Endoscopic ultrasonography was used to evaluate EI post ablation. EI was classified as a category 1 (erythema or erosion) or a category 2 (hematoma or ulceration). Results Compared with the AI‐400 group (59.9±8.4 years; male, 60%), the AI‐350 group (59.1 ± 9.9 years; male, 50%) had a lower incidence of EI (3.3% vs 26.7%,P = 0.03). There was no significant difference in the percentage of first‐pass PVI between the AI‐400 group and the AI‐350 group (left PVI: 80% vs 73.4%, P = 0.54; right PVI: 80% vs 60%, P = 0.1). Neither ablation time nor fluoroscopy time was significantly different between the AI‐400 group and the AI‐350 group. Conclusions AF ablation guide by AI target value of 350 may reduce esophageal thermal injury and have a similar efficiency on the acute success rate of first‐pass PVI compared with an AI target value of 400 at the posterior wall. This article is protected by copyright. All rights reservedKeywords
This publication has 24 references indexed in Scilit:
- 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillationHeart Rhythm, 2017
- Prospective use of Ablation Index targets improves clinical outcomes following ablation for atrial fibrillationJournal of Cardiovascular Electrophysiology, 2017
- Gastric hypomotility after second-generation cryoballoon ablation—Unrecognized silent nerve injury after cryoballoon ablationHeart Rhythm, 2017
- Determinants of Acute and Late Pulmonary Vein Reconnection in Contact Force–Guided Pulmonary Vein IsolationCirculation: Arrhythmia and Electrophysiology, 2017
- Ablation index, a novel marker of ablation lesion quality: prediction of pulmonary vein reconnection at repeat electrophysiology study and regional differences in target valuesEP Europace, 2016
- EFFICAS II: optimization of catheter contact force improves outcome of pulmonary vein isolation for paroxysmal atrial fibrillationEP Europace, 2015
- Pulmonary vein isolation using “contact force” ablation: The effect on dormant conduction and long-term freedom from recurrent atrial fibrillation—A prospective studyHeart Rhythm, 2014
- Higher contact-force values associated with better mid-term outcome of paroxysmal atrial fibrillation ablation using the SmartTouch™ catheterEP Europace, 2014
- Damage to the Esophagus After Atrial Fibrillation AblationCirculation: Arrhythmia and Electrophysiology, 2010
- Prevalence and Causes of Fatal Outcome in Catheter Ablation of Atrial FibrillationJournal of the American College of Cardiology, 2009