Incidence of Significant Delayed Esophageal Temperature Drop After Cryoballoon-Based Pulmonary Vein Isolation

2016 ◽  
Vol 27 (8) ◽  
pp. 913-917 ◽  
Author(s):  
SEBASTIAN DEISS ◽  
ANDREAS METZNER ◽  
FEIFAN OUYANG ◽  
ROLAND R. TILZ ◽  
SHIBU MATHEW ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Temperature Drop ◽  
Esophageal Temperature

scholarly journals Gastric Hypomotility After Luminal Esophageal Temperature Guided Second-Generation Cryoballoon Pulmonary Vein Isolation

2018 ◽  
Vol 11 (8) ◽  
Author(s):  
Kanae Hasegawa ◽  
Shinsuke Miyazaki ◽  
Kaori Hisazaki ◽  
Kenichi Kaseno ◽  
Naoki Amaya ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Second Generation ◽  
Esophageal Temperature

scholarly journals Low Incidence of Esophageal Lesions After Pulmonary Vein Isolation Using Contact-Force Sensing Catheter Without Esophageal Temperature Probe

2017 ◽  
Vol 58 (6) ◽  
pp. 880-884 ◽  
Author(s):  
Christian Blockhaus ◽  
Patrick Müller ◽  
Stephan vom Dahl ◽  
Silke Leonhardt ◽  
Dieter Häussinger ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Contact Force ◽  
Force Sensing ◽  
Esophageal Temperature ◽  
Temperature Probe ◽  
Low Incidence

Impact of High-Power Short-Duration Radiofrequency Ablation on Esophageal Temperature Dynamic

2021 ◽  
Author(s):  
Hagai D. Yavin ◽  
Zachary P. Bubar ◽  
Koji Higuchi ◽  
Jakub Sroubek ◽  
Mohamed Kanj ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Pulmonary Vein ◽  
Short Duration ◽  
Pulmonary Vein Isolation ◽  
High Power ◽  
Temperature Rise ◽  
Esophageal Injury ◽  
Esophageal Temperature ◽  
Dynamic Profile ◽  
Temperature Dynamic

Background: High-power short-duration (HP-SD) radiofrequency ablation (RFA) has been proposed as a method for producing rapid and effective lesions for pulmonary vein isolation. The underlying hypothesis assumes an increased resistive heating phase and decreased conductive heating phase, potentially reducing the risk for esophageal thermal injury. The objective of this study was to compare the esophageal temperature dynamic profile between HP-SD and moderate-power moderate-duration (MP-MD) RFA ablation strategies. Methods: In patients undergoing pulmonary vein isolation, RFA juxtaposed to the esophagus was delivered in an alternate sequence of HP-SD (50 W, 8–10 s) and MP-MD (25 W, 15–20 s) between adjacent applications (distance, ≤4 mm). Esophageal temperature was recorded using a multisensor probe (CIRCA S-CATH). Temperature data included magnitude of temperature rise, maximal temperature, time to maximal temperature, and time return to baseline. In swine, a similar experimental design compared the effect of HP-SD and MP-MD on patterns of esophageal injury. Results: In 20 patients (68.9±5.8 years old; 60% persistent atrial fibrillation), 55 paired HP-SD and MP-MD applications were analyzed. The esophageal temperature dynamic profile was similar between HP-SD and MP-MD ablation strategies. Specifically, the magnitude of temperature rise (2.1 °C [1.4–3] versus 2.0 °C [1.5–3]; P =0.22), maximal temperature (38.4 °C [37.8–39.3] versus 38.5 °C [37.9–39.4]; P =0.17), time to maximal temperature (24.9±7.5 versus 26.3±6.8 s; P =0.1), and time of temperature to return to baseline (110±23.2 versus 111±25.1 s; P =0.86) were similar between HP-SD and MP-MD ablation strategies. In 6 swine, esophageal injury was qualitatively similar between HP-SD and MP-MD strategies. Conclusions: Esophageal temperature dynamics are similar between HP-SD and MP-MD RFA strategies and result in comparable esophageal tissue injury. Therefore, when using a HP-SD RFA strategy, the shorter application duration should not prompt shorter intervals between applications.

Esophageal temperature change and esophageal thermal lesions after pulmonary vein isolation using the novel endoscopic ablation system

Heart Rhythm ◽  
2011 ◽  
Vol 8 (6) ◽  
pp. 815-820 ◽  
Author(s):  
Andreas Metzner ◽  
Boris Schmidt ◽  
Alexander Fuernkranz ◽  
Erik Wissner ◽  
Roland Richard Tilz ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Temperature Change ◽  
Pulmonary Vein Isolation ◽  
The Novel ◽  
Esophageal Temperature ◽  
Thermal Lesions ◽  
Endoscopic Ablation

Luminal esophageal temperature rise and esophageal lesion formation following remote-controlled magnetic pulmonary vein isolation

Heart Rhythm ◽  
2011 ◽  
Vol 8 (12) ◽  
pp. 1875-1880 ◽  
Author(s):  
Melanie Konstantinidou ◽  
Erik Wissner ◽  
Julian K.R. Chun ◽  
Buelent Koektuerk ◽  
Andreas Metzner ◽  
...  
Keyword(s):  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Temperature Rise ◽  
Esophageal Temperature ◽  
Lesion Formation ◽  
Esophageal Lesion

scholarly journals First insight into a novel irrigated radiofrequency ablation balloon

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
S Bordignon ◽  
S Tohoku ◽  
S Chen ◽  
F Bologna ◽  
C Throm ◽  
...  
Keyword(s):  
Real Time ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Single Shot ◽  
Esophageal Temperature ◽  
Phrenic Nerve Palsy ◽  
Funding Sources ◽  
Thermal Lesions ◽  
Ostial Lesion ◽  
Mean Time

Abstract Funding Acknowledgements Type of funding sources: None. Background A novel irrigated RF balloon (RFB) for pulmonary vein isolation (PVI) was recently released in selected centers . It is a 28 mm open irrigated balloon with 10 unipolar electrodes on its surface to deploy a circular ostial lesion set around the PVs. An inner lumen spiral catheter allows for real time PVI visualization during the ablation. Methods Data from consecutive RFB procedures were collected and analysed. After a single transseptal puncture and selective PV angiograms a 3D map of the left atrium was acquired. Sequential PVI was performed using the RFB: each application lasted 60 seconds, the posterior electrodes were identified to stop the energy delivery after 20 seconds. Real time to isolation data were acquired. A 3D bipolar remap was finally performed to observe the level of isolation. A temperature probe was used to monitor the local esophageal temperature (LET) with a cut off of 39°C. Acute procedural data and complication were collected. Endoscopy was scheduled the day after procedure. Results Data from 10 consecutive RFB procedures were analyzed: 6/10  patients were male, 67 ± 9 years old, 8/10 with history of paroxysmal AF. A total of 36 PVs were targeted and isolated with the RFB, with a mean of 7,3 ± 4,0 applications per patient and 2,0 ± 1,2 applications per PV. First pass "single shot"  isolation was achieved in 22/36 (61%), time to isolation during the first application was observed in 29/36 (80%) PVs, but an acute reconnection was observed in  10/29 (35%) isolated PVs. Mean time to sustained isolation was 13 ± 5 sec., mean time to non-sustained isolation was significantly longer (29 ± 17 sec; p = 0,001). Procedure time was 57 ± 16 min., left atrial dwell time 50 ± 14 min, ablation phase time 29 ± 14 min and fluoroscopy time was 10 ± 4 minutes. An esophageal temperature above 39°C was recorded in 2/36 PVs. No phrenic nerve palsy was recorded. 7/10 patients underwent endoscopy and no thermal lesions were detected. No other complications were recorded. Conclusion The novel irrigated RFB seems to allow an effective, safe and fast pulmonary vein isolation. More studies are needed to optimize energy dosing to possibly increase the rate of durable single shot PVI.

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