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

Autor: Abdulsalam NM; Division of Cardiology, PeaceHealth Southwest Medical Center, 400 NE Mother Jospeh PI, WA, 98664, Vancouver, USA. nashwaabdulsalam@gmail.com., Sridhar AM; Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA., Tregoning DM; Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA., He BJ; Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA., Jafarvand M; Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA., Mehri A; Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA., Afroze T; Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA., Chahine Y; Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA., Ko CW; Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA., Akoum N; Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA.
Jazyk: angličtina
Zdroj: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing [J Interv Card Electrophysiol] 2023 Nov; Vol. 66 (8), pp. 1827-1835. Date of Electronic Publication: 2023 Feb 06.
DOI: 10.1007/s10840-023-01492-1
Abstrakt: Background: Esophageal luminal temperature monitoring is a commonly used strategy to reduce esophageal thermal injury in catheter ablation for atrial fibrillation (AFib).
Objectives: We sought to compare the incidence of endoscopically detected esophageal lesions (EDEL) between two commonly used esophageal luminal temperature probes.
Methods: Consecutive patients undergoing ablation with esophageal luminal temperature monitoring and upper endoscopy within 24 h after ablation were included.
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: 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.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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