Ablation of atrial fibrillation and esophageal injury: Effects of energy source and ablation technique
| Autor: | Heike Aupperle, Patrick Kornherr, Friedrich W. Mohr, Nicolas Doll, Thomas Walther, Heinz-Adolf Schoon, C. Ullmann |
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| Rok vydání: | 2005 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Pathology medicine.medical_treatment Ablation of atrial fibrillation Cryosurgery Lesion Esophagus Atrial Fibrillation medicine Animals Microwaves Sheep business.industry Lasers Cryoablation Atrial fibrillation Ablation medicine.disease Esophageal Tissue medicine.anatomical_structure Catheter Ablation Female Surgery Radiology medicine.symptom business Energy source Cardiology and Cardiovascular Medicine |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 130(6):1549-1554 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2005.06.052 |
| Popis: | Objective The aim of this study was the evaluation of histologic changes induced on the esophagus by surgical ablation therapy for atrial fibrillation. Methods Experiments were performed on 39 sheep. Circular lesions were created endocardially or epicardially in the left atrium and at the pulmonary veins by using different energy sources: cryoablation, microwave, laser, and unipolar or bipolar radiofrequency. Temperatures inside the esophagus were measured, and esophageal tissue was investigated macroscopically and histopathologically. Results Esophageal damage was seen histologically in 24 of 39 cases. The epithelium was intact in all cases. Unipolar radiofrequency induced the most intensive esophageal lesions in 4 of 6 cases. The affected areas were small (1.56-3.01 mm) but reached deep into the tissue. Endocardial cryoablation resulted in wider lesions (2.01-8.54 mm), which were intensive in only 2 of 6 cases. Epicardial cryoablation and bipolar radiofrequency induced wide (1.11-6.8 mm) but mainly mild alterations. Endocardial and epicardial microwave energy affected the esophagus in single cases, and lesions were small (0.97-2.81 mm). Only in 1 case did laser energy induce a moderate alteration (5.30 mm) of the esophageal wall. Conclusions Esophageal alterations were found in numerous cases. However, marked lesions were especially induced by endocardial unipolar radiofrequency and cryoablation. |
| Databáze: | OpenAIRE |
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