Comparative study of strategies to prevent esophageal and periesophageal injury during atrial fibrillation ablation

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art_OLIVEIRA_Comparative_study_of_strategies_to_prevent_esophageal_and_2020.PDF (2.1 MB)
Citações na Scopus
6
Tipo de produção
article
Data de publicação
2020
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
OLIVEIRA, Barbara D. de
Citação
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, v.31, n.4, p.924-933, 2020
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Objective To compare the prevalence of esophageal and periesophageal thermal injury in patients undergoing radiofrequency (RF) atrial fibrillation (AF) ablation using 8 mm tip catheters during three different esophageal protection strategies. Methods Forty-five consecutive patients with paroxysmal or persistent AF underwent first ablation procedure, besides esophagogastroduodenoscopy (EGD) combined with radial endosonography (EUS) performed before and after the pulmonary vein (PV) isolation. Before the procedure, patients were randomly assigned to one of three esophageal lesion protection strategies: group I-without any protective or monitoring dispositive and limiting RF applications to 30 W for 20 seconds, in left atrium posterior wall (LAPW); group II-power and time of RF delivery, up to 50 W for 20 seconds at LAPW, limited by esophageal temperature monitoring; group III-applications of RF in LAPW with fixed power application of 50 W for 20 seconds during continuous esophageal cooling. Results Baseline characteristics of patients were similar in all groups. The four PVs were isolated in 14 (93.3%), 13 (86.7%), and 15 (100%) patients, respectively in groups I, II, and III. The mean RF power was significantly higher (P < .001) in the posterior side of PVs in group III. Post-AF ablation EGD and EUS revealed two esophageal wall ulcerations and two periesophageal mediastinal edemas only in the esophageal cooling group (P = .008). Conclusion Esophageal cooling balloon strategy resulted in a higher RF power energy delivery when ablating at the LA posterior wall, using 8 mm nonirrigated tip catheters under temperature mode control. Despite that, patients presented a relatively low incidence of esophageal and periesophaeal injuries.
Palavras-chave
atrial fibrillation, catheter ablation, complications, esophageal cooling, esophageal temperature monitoring, esophageal, periesophageal lesion
URI
https://observatorio.fm.usp.br/handle/OPI/35961
Referências
  1. Arruda MS, 2009, J CARDIOVASC ELECTR, V20, P1272, DOI 10.1111/j.1540-8167.2009.01536.x
  2. Aryana A, 2008, J CARDIOVASC ELECTR, V19, P32, DOI 10.1111/j.1540-8167.2007.00975.x
  3. Aupperle H, 2005, J THORAC CARDIOV SUR, V130, P1549, DOI 10.1016/j.jtcvs.2005.06.052
  4. Bahnson TD, 2009, PACE, V32, P248, DOI 10.1111/j.1540-8159.2008.02210.x
  5. Berjano EJ, 2005, PHYS MED BIOL, V50, pN269, DOI 10.1088/0031-9155/50/20/N03
  6. Bunch TJ, 2013, J CARDIOVASC ELECTR, V24, P33, DOI 10.1111/j.1540-8167.2012.02441.x
  7. Calkins H, 2012, EUROPACE, V14, P528, DOI 10.1093/europace/eus027
  8. Cappato R, 2010, CIRC-ARRHYTHMIA ELEC, V3, P32, DOI 10.1161/CIRCEP.109.859116
  9. Cappato R, 2009, J AM COLL CARDIOL, V53, P1798, DOI 10.1016/j.jacc.2009.02.022
  10. Cummings JE, 2006, ANN INTERN MED, V144, P572, DOI 10.7326/0003-4819-144-8-200604180-00007
  11. Cummings JE, 2005, CIRCULATION, V112, P459, DOI 10.1161/CIRCULATIONAHA.104.509612
  12. Cummings JE, 2008, J CARDIOVASC ELECTR, V19, P641, DOI 10.1111/j.1540-8167.2008.01130.x
  13. Di Biase L, 2009, CIRC-ARRHYTHMIA ELEC, V2, P108, DOI 10.1161/CIRCEP.108.815266
  14. Ghia KK, 2009, J INTERV CARD ELECTR, V24, P33, DOI 10.1007/s10840-008-9307-1
  15. Halm U, 2010, AM J GASTROENTEROL, V105, P551, DOI 10.1038/ajg.2009.625
  16. Leite LR, 2011, CIRC-ARRHYTHMIA ELEC, V4, P149, DOI 10.1161/CIRCEP.110.960328
  17. Magalhaes LP, 2016, ARQ BRAS CARDIOL, V106, P1
  18. Marrouche NF, 2007, J CARDIOVASC ELECTR, V18, P583, DOI 10.1111/j.1540-8167.2007.00879.x
  19. Martinek M, 2009, J CARDIOVASC ELECTR, V20, P726, DOI 10.1111/j.1540-8167.2008.01426.x
  20. Martinek M, 2010, HEART RHYTHM, V7, P1224, DOI 10.1016/j.hrthm.2010.02.027
  21. Medi C, 2011, J CARDIOVASC ELECTR, V22, P137, DOI 10.1111/j.1540-8167.2010.01885.x
  22. Ouyang F, 2010, CIRCULATION, V122, P2368, DOI 10.1161/CIRCULATIONAHA.110.946806
  23. Pappone C, 2004, CIRCULATION, V109, P2724, DOI 10.1161/01.CIR.0000131866.44650.46
  24. Perzanowski C, 2006, J CARDIOVASC ELECTR, V17, P166, DOI 10.1111/j.1540-8167.2005.00333.x
  25. Pisani CF, 2008, J CARDIOVASC ELECTR, V19, P211, DOI 10.1111/j.1540-8167.2007.00937.x
  26. Redfearn DP, 2005, J CARDIOVASC ELECTR, V16, P589, DOI 10.1111/j.1540-8167.2005.40825.x
  27. Rillig A, 2010, EUROPACE, V12, P655, DOI 10.1093/europace/euq061
  28. Sanchez-Quintana D, 2005, CIRCULATION, V112, P1400, DOI 10.1161/CIRCULATIONAHA.105.551291
  29. Sause A, 2010, BMC CARDIOVASC DISOR, V10, DOI 10.1186/1471-2261-10-52
  30. Sawhney N, 2009, AM J CARDIOL, V104, P366, DOI 10.1016/j.amjcard.2009.03.044
  31. Scanavacca MI, 2004, J CARDIOVASC ELECTR, V15, P960, DOI 10.1046/j.1540-8167.2004.04083.x
  32. Shah D, 2005, J AM COLL CARDIOL, V46, P327, DOI 10.1016/j.jacc.2005.04.030
  33. Singh SM, 2008, HEART RHYTHM, V5, P1548, DOI 10.1016/j.hrthm.2008.08.027
  34. Singh SM, 2008, CIRC-ARRHYTHMIA ELEC, V1, P162, DOI [10.1161/CIRCEP.107.789552, 10.1161/CIRCEP.108.789552]
  35. Tilz RR, 2010, J CARDIOVASC ELECTR, V21, P853, DOI 10.1111/j.1540-8167.2010.01742.x
  36. Tsuchiya T, 2007, J CARDIOVASC ELECTR, V18, P145, DOI 10.1111/j.1540-8167.2006.00693.x
  37. Vijayaraman P, 2009, CIRC-ARRHYTHMIA ELEC, V2, pE31, DOI 10.1161/CIRCEP.109.883694
  38. Yamasaki H, 2011, HEART RHYTHM, V8, P826, DOI 10.1016/j.hrthm.2011.01.045
  39. Yokoyama K, 2008, CIRC-ARRHYTHMIA ELEC, V1, P354, DOI 10.1161/CIRCEP.108.803650
  40. Zellerhoff S, 2010, CIRC-ARRHYTHMIA ELEC, V3, P155, DOI 10.1161/CIRCEP.109.915918

Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/08
Artigos e Materiais de Revistas Científicas - LIM/35
Artigos e Materiais de Revistas Científicas - LIM/65