Incidence of Esophageal Thermal Injury Using a Safety Protocol During Atrial Fibrillation Ablation

  • Anibal Pires Borges Hospital São Francisco – Santa Casa de Misericórdia – Porto Alegre/RS – Brazil. https://orcid.org/0000-0002-3617-9589
  • Guilherme Ferreira Gazzoni Hospital São Francisco – Santa Casa de Misericórdia – Porto Alegre/RS – Brazil. https://orcid.org/0000-0001-5019-2475
  • José Plutarco Gutierrez Yanéz Hospital São Francisco – Santa Casa de Misericórdia – Porto Alegre/RS – Brazil.
  • Karina de Andrade Hospital São Francisco – Santa Casa de Misericórdia – Porto Alegre/RS – Brazil. https://orcid.org/0000-0002-6127-4617
  • Celine de Oliveira Boff Hospital São Francisco – Santa Casa de Misericórdia – Porto Alegre/RS – Brazil. https://orcid.org/0000-0001-8575-4845
  • Flávio Vinícius Costa Ferreira Hospital São Francisco – Santa Casa de Misericórdia – Porto Alegre/RS – Brazil. https://orcid.org/0000-0002-7186-707X
  • Eduardo Bartholomay Hospital São Francisco – Santa Casa de Misericórdia – Porto Alegre/RS – Brazil.
  • Álvaro Machado Rösler Hospital São Francisco – Santa Casa de Misericórdia – Porto Alegre/RS – Brazil. https://orcid.org/0000-0003-4727-3367
  • Fernando Antonio Lucchese Hospital São Francisco – Santa Casa de Misericórdia – Porto Alegre/RS – Brazil. https://orcid.org/0000-0001-9532-2384
  • Carlos Antonio Kalil Hospital São Francisco – Santa Casa de Misericórdia – Porto Alegre/RS – Brazil.
Keywords: Atrial fibrillation, Catheter ablation, Esophageal injury, Esophageal temperature monitoring

Abstract

Objective: Catheter ablation has been a common procedure used for the management of atrial fibrillation (AF). Atrioesophagel fistula (AEF) is one of the most feared complications of AF ablation. Although it is a rare complication, severe esophageal thermal injury must be avoided. It is important to describe a safe method of preventing esophageal injuries without increasing AF recurrence. Methods: A retrospective cohort study of consecutive patients who underwent radiofrequency AF catheter ablation during 1 year-period wa conducted. One hundred and four patients were enrolled divided in two groups: one with a maximum recorded esophageal temperature (ET) < 38 °C and other with a maximum recorded ET ≥ 38 °C. The primary endpoint was detection of endoscopic esophageal lesions after AF ablation and the secondary endpoint was AF recurrence according to the maximum ET reached during the procedure. Results: The maximum ET was on average 37.3 ± 1.0 °C. Only 4 (3.8%) patients had esophageal lesion diagnosed by upper gastrointestinal endoscopy. There were no cases of esophageal perforation. The AF recurrence rate was 9.6% during the follow-up (10 patients, 3 from the ET max < 38 °C group and 7 from the ET max ≥ 38 °C group; p = 0.181). The maximum ET was not associated with AF recurrence after catheter ablation (OR = 1.65, 95% CI = 0.84-3.24, p = 0.14). Conclusions: A low incidence of esophageal injury after AF ablation with the use of a specific esophageal protection protocol was found. There was no esophageal perforation. The AF recurrence rate was similar to that described in the literature.

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References

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Published
18-09-2020
How to Cite
Borges, A., Gazzoni, G., Yanéz, J., Andrade, K., Boff, C., Ferreira, F., Bartholomay, E., Rösler, Álvaro, Lucchese, F., & Kalil, C. (2020). Incidence of Esophageal Thermal Injury Using a Safety Protocol During Atrial Fibrillation Ablation. JOURNAL OF CARDIAC ARRHYTHMIAS, 33(4). Retrieved from https://jca.org.br/jca/article/view/3413
Section
Electrophysiology