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- Title
Esophagus-Related Complications During Second-Generation Cryoballoon Ablation-Insight from Simultaneous Esophageal Temperature Monitoring from 2 Esophageal Probes.
- Authors
MIYAZAKI, SHINSUKE; NAKAMURA, HIROAKI; TANIGUCHI, HIROSHI; TAKAGI, TAKAMITSU; IWASAWA, JIN; WATANABE, TOMONORI; HACHIYA, HITOSHI; HIRAO, KENZO; IESAKA, YOSHITO
- Abstract
Esophagus-Related Complications After Cryoablation Background Monitoring luminal esophageal temperatures (LETs) helps predict esophageal thermal lesions (ETLs) after catheter ablation. This study aimed to evaluate esophagus-related complications after second-generation cryoballoon ablation under simultaneous LETs monitoring from 2 esophageal probes. Methods Forty consecutive paroxysmal atrial fibrillation patients undergoing second-generation cryoballoon ablation under conscious sedation followed by esophagogastroscopy were prospectively included. Two temperature probes inserted bi-nasally (both non-deflectable in 13, non-deflectable and deflectable in 27 patients) were used for LET monitoring. Pulmonary vein isolation was performed with one 28-mm balloon using single 3-minute freeze techniques. Results The lowest LETs significantly correlated between different probes; however, deflectable probe showed significantly lower nadir LETs than non-deflectable probes (14.6 ± 9.2 vs. 20.0 ± 10.6 ℃, P<0.0001). Esophagogastroscopy post-ablation demonstrated ETLs and gastroparesis in 8 (20%) and 7 (17.5%) patients (total 13 [32.5%]), respectively. The optimal cutoff for the lowest LET measured on any probe for predicting no ETLs was 12.8 ℃ (sensitivity 78.1%, specificity 100%). When using deflectable and non-deflectable catheters, the optimal cutoff point for the lowest LET for predicting no ETLs was 11.4 ℃ (sensitivity 70.0%, specificity 100%) and 19.4 ℃ (sensitivity 63.6%, specificity 100%), respectively. No ETLs were detected in 12 (30%) patients with the esophagus located between the left atrium and spine. All esophagus-related complications were asymptomatic and had healed on repeat esophagogastroscopy by a mean of 53 ± 25 days after the procedure. Conclusions The lowest LET highly depended on the temperature probe location. However, if a different cutoff value was applied, LET monitoring, regardless of the probe type, and anatomical information might help predict ETLs during second-generation cryoballoon ablation.
- Subjects
JAPAN; ESOPHAGEAL injuries; ATRIAL fibrillation; MEDICAL thermometry; CATHETER ablation; CLINICAL medicine research; CONFIDENCE intervals; GASTROSCOPY; LONGITUDINAL method; PULMONARY veins; STATISTICAL sampling; T-test (Statistics); DESCRIPTIVE statistics; GASTROPARESIS; MANN Whitney U Test
- Publication
Journal of Cardiovascular Electrophysiology, 2016, Vol 27, Issue 9, p1038
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.13015