Universität zu Köln

Stauber, Annina, Kornej, Jelena, Bollmann, Andreas, Hindricks, Gerhard and Sommer, Philipp (2020). Relevance of esophageal position and temperature on thermal injuries and rhythm outcome in atrial fibrillation ablations. PACE-Pacing Clin. Electrophysiol., 43 (2). S. 194 - 201. HOBOKEN: WILEY. ISSN 1540-8159

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Abstract

Background Thermolesions are a dangerous complication of atrial fibrillation (AF) ablation. We aimed to assess the reasons for thermolesions and the effect of esophageal position on recurrences. Methods The study included consecutive patients undergoing AF catheter ablation at Heart Center Leipzig between January and September 2014. We collected data of esophagus localization, temperature, endoscopy, and follow-up. Results The study included 645 patients into analyses. A total of 626 (97.2%) received a temperature probe. Esophageal position was categorized: (A) behind left pulmonary veins, (B) left ostial, (C) in the middle of left atrium, (D) right ostial, and (E) behind right pulmonary veins. The most frequent esophageal position was B-C (n = 201, 32.1%), followed by B (n = 161, 25.7%), and C (n = 147, 23.5%). The temperature was highest in A-B positions (42.04 degrees C) and in D-E positions (41.70 degrees C). There was a significant correlation between the endoscopically detected esophageal lesions (EDEL) and the esophageal position (r(2) = -.115, P = .004) and the esophageal temperature (r(2) = .162, P = .000), but not with body mass index (BMI) (r(2) = -.016, P = .688). Additional substrate modification in the left atrium resulted in significantly higher esophageal temperatures (P < .001) and more frequent EDEL (P = .049). An EDEL was found in 15 patients (2.3% of all patients, 5.6% of patients receiving endoscopy). Of those, the median esophageal temperature was 41.8 degrees C (interquartile range [IQR]: 41.2-42.4). Neither esophageal position nor temperature during ablation was associated with arrhythmia recurrences (both P > .400). Conclusions EDEL depended on the esophageal position and temperature, but not on BMI. Esophageal position and intraluminal temperature during ablation had no effect on recurrences.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Stauber, Annina UNSPECIFIED UNSPECIFIED UNSPECIFIED Kornej, Jelena UNSPECIFIED UNSPECIFIED UNSPECIFIED Bollmann, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hindricks, Gerhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Sommer, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-347549
DOI:	10.1111/pace.13865
Journal or Publication Title:	PACE-Pacing Clin. Electrophysiol.
Volume:	43
Number:	2
Page Range:	S. 194 - 201
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1540-8159
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PULMONARY VEIN ISOLATION; CATHETER ABLATION; LESIONS Multiple languages Cardiac & Cardiovascular Systems; Engineering, Biomedical Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34754