Open AccessImpact of esophageal temperature monitoring guided atrial fibrillation ablation on preventing asymptomatic excessive transmural injury
Author(s) -
Kiuchi Kunihiko,
Okajima Katsunori,
Shimane Akira,
Kanda Gaku,
Yokoi Kiminobu,
Teranishi Jin,
Aoki Kousuke,
Chimura Misato,
Toba Takayoshi,
Oishi Shogo,
Sawada Takahiro,
Tsukishiro Yasue,
Onishi Tetsuari,
Kobayashi Seiichi,
Taniguchi Yasuyo,
Yamada Shinichiro,
Yasaka Yoshinori,
Kawai Hiroya,
Yoshida Akihiro,
Fukuzawa Koji,
Itoh Mitsuaki,
Imamura Kimitake,
Fujiwara Ryudo,
Suzuki Atsushi,
Nakanishi Tomoyuki,
Yamashita Soichiro,
Hirata Kenichi,
Tada Hiroshi,
Yamasaki Hiro,
Naruse Yoshihisa,
Igarashi Miyako,
Aonuma Kazutaka
Publication year - 2016
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2015.07.003
Subject(s) - medicine , atrial fibrillation , asymptomatic , cardiology , ablation
Background Even with the use of a reduced energy setting (20–25 W), excessive transmural injury (ETI) following catheter ablation of atrial fibrillation (AF) is reported to develop in 10% of patients. However, the incidence of ETI depends on the pulmonary vein isolation (PVI) method and its esophageal temperature monitor setting. Data comparing the incidence of ETI following AF ablation with and without esophageal temperature monitoring (ETM) are still lacking. Methods This study was comprised of 160 patients with AF (54% paroxysmal, mean: 24.0±2.9 kg/m 2 ). Eighty patients underwent ablation accompanied by ETM. The primary endpoint was defined as the occurrence of ETI assessed by endoscopy within 5 d after the AF ablation. The secondary endpoint was defined as AF recurrence after a single procedure. If the esophageal temperature probe registered >39 °C, the radiofrequency (RF) application was stopped immediately. RF applications could be performed in a point‐by‐point manner for a maximum of 20 s and 20 W. ETI was defined as any injury that resulted from AF ablation, including esophageal injury or periesophageal nerve injury (peri‐ENI). Results The incidence of esophageal injury was significantly lower in patients whose AF ablation included ETM compared with patients without ETM (0 [0%] vs. 6 [7.5%], p =0.028), but not the incidence of peri‐ENI (2 [2.5%] vs. 3 [3.8%], p =1.0). AF recurrence 12 months after the procedure was similar between the groups (20 [25%] in the ETM group vs. 19 [24%] in the non‐ETM group, p =1.00). Conclusions Catheter ablation using ETM may reduce the incidence of esophageal injury without increasing the incidence of AF recurrence but not the incidence of peri‐ENI.