scholarly journals Incidence of acute thermal esophageal injury after atrial fibrillation ablation guided by prespecified ablation index

2019 ◽  
Vol 30 (11) ◽  
pp. 2256-2261 ◽  
Author(s):  
Philipp Halbfass ◽  
Artur Berkovitz ◽  
Borche Pavlov ◽  
Kai Sonne ◽  
Karin Nentwich ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Atrial Fibrillation Ablation ◽  
Esophageal Injury ◽  
Ablation Index

Standard versus strict stability criteria in radiofrequency paroxysmal atrial fibrillation ablation using ablation index

2021 ◽  
Author(s):  
G. Zucchelli ◽  
M. Parollo ◽  
F. Guarracini ◽  
M. Marini ◽  
A. Di Cori ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Paroxysmal Atrial Fibrillation ◽  
Atrial Fibrillation Ablation ◽  
Stability Criteria ◽  
Ablation Index ◽  
Strict Stability

scholarly journals Catheter-related complications and mortality of atrial fibrillation ablation following introduction of contact force-sensing technology

2020 ◽  
Vol 2 (1) ◽  
pp. e000058
Author(s):  
Joseph G Akar ◽  
James P Hummel ◽  
Xiaoxi Yao ◽  
Lindsey Sangaralingham ◽  
Sanket Dhruva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Acute Care ◽  
Contact Force ◽  
Emergency Department Visits ◽  
Atrial Fibrillation Ablation ◽  
Esophageal Injury ◽  
Force Sensing ◽  
Complication Rates ◽  
Af Ablation ◽  
Complications And Mortality

ObjectivesContact force-sensing catheters allow real-time catheter-tissue contact force monitoring during atrial fibrillation. These catheters were rapidly adopted into clinical practice following market introduction in 2014, but concerns have been raised regarding collateral damage such as esophageal injury. We sought to examine whether the introduction of force-sensing catheters was associated with a change in short-term and intermediate-term acute care use, complications and mortality following atrial fibrillation ablation.DesignRetrospective cohort analysis. We used inverse probability treatment weight matching to account for the differences in baseline characteristics between groups.SettingWe examined patients included in the OptumLabs Data Warehouse who underwent ablation for atrial fibrillation before (2011–2013) and after (2015–2017) the market introduction of contact force-sensing catheters.Main outcome measuresWe examined 30-day and 90-day rates of all-cause acute care use, including hospitalizations and emergency department visits, as well as death and hospitalization for catheter-related complications, including atrioesophageal fistula, pericarditis, cardiac tamponade/perforation and stroke/transient ischemic attack.ResultsOur sample included 3470 and 5772 patients who underwent atrial fibrillation (AF) ablation before and after market introduction of contact force-sensing catheters, respectively. Complication rates were low and did not differ between the two periods (p>0.10 for each outcome). The 30-day and 90-day mortality was 0.1% and 0.3%, respectively after market introduction and unchanged from prior to 2014. The 90-day rates of all-cause acute care use decreased, from 27.0% in 2011–2013 to 23.9% in 2015–2017 (p<0.001).ConclusionsAF ablation-related catheter complications and mortality are low and there has been no significant change following the introduction of force-sensing catheters.

scholarly journals Evaluation of a new approach for persistent atrial fibrillation: Ablation index-guided pulmonary veins isolation with contiguous lesions

2019 ◽  
Vol 11 (1) ◽  
pp. 80
Author(s):  
P. Taghji ◽  
Sok-Sithikun Bun ◽  
B. Enache ◽  
Decebal Gabriel Latcu ◽  
N. Saoudi
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Veins ◽  
Persistent Atrial Fibrillation ◽  
Atrial Fibrillation Ablation ◽  
New Approach ◽  
Ablation Index

scholarly journals Esophageal Injury and Temperature Monitoring During Atrial Fibrillation Ablation

2008 ◽  
Vol 1 (3) ◽  
pp. 162-168 ◽  
Author(s):  
Sheldon M. Singh ◽  
Andre d'Avila ◽  
Shephal K. Doshi ◽  
William R. Brugge ◽  
Rudolph A. Bedford ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Temperature Monitoring ◽  
Atrial Fibrillation Ablation ◽  
Esophageal Injury

1244Feasibility, safety and efficacy of tailoring ablation index to left atrial wall thickness (lawt) during atrial fibrillation ablation. The Ablate By-LAW Study

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
C Teres ◽  
B Jauregui ◽  
D Soto-Iglesias ◽  
A Ordonez ◽  
A Chauca ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Wall Thickness ◽  
Left Atrial ◽  
Atrial Fibrillation Ablation ◽  
High Rate ◽  
Atrial Wall ◽  
Left Atrial Wall ◽  
Ablation Index ◽  
First Pass ◽  
Catheter Stability

Abstract Funding Acknowledgements Dr Teres was funded by Swiss Heartrhythm Foundation Introduction Circumferential pulmonary vein isolation (PVI) has become a mainstay in the treatment of atrial fibrillation (AF). The utility of ablation index (AI) to dose radiofrequency delivery for the reduction of AF recurrences has already been proven with a target AI ≥ 400 at the posterior wall and ≥550 at the anterior Wall. Nevertheless, the left atrial wall is a thin, heterogeneous structure with an important inter and intra-patient variability of LAWT. Objective To determine if adapting AI to atrial wall thickness (AWT) is feasible, effective and safe during AF ablation. Methods Single-Center study that included 80 consecutive patients referred for a first paroxysmal AF ablation that was performed with a single catheter approach with the intention to reduce vascular access complication rate. All patients had a MDCT prior to the ablation procedure. LAWT maps were semi-automatically computed from the MDCT as the local distance between the LA endo and epicardium. All procedures were performed under general anesthesia with a high-rate low-volume ventilation protocol for obtaining higher catheter stability. The transeptal puncture was TEE-guided. During the procedure, the WT map was fused with the LA anatomy using CARTO-merge. LAWT was categorized into 1mm-layers and the AI was titrated to the local atrial WT as follows: Thickness &lt; 1 mm (red): 300; 1-2 mm (yellow): 350; 2-3 mm (green): 400; 3-4 mm (blue): 450; &gt; 4 mm (purple): 450 (Figure). Maximal inter-lesion distance was set at 6 mm. VisiTag settings were: catheter position stability: minimum time 3 s, maximum range 4 mm; force over time: 25%, minimum force 3 g; lesion tag size: 3 mm. Respiration training was not possible due to the high catheter stability.  The circumferential ablation line was designed in a personalized fashion to avoid thicker regions. Results 80 patients [41 (51,2 %) male, age 60± 11 years] were included. Mean LVEF was 59 ± 5 %, Mean LA diameter 39,1 ± 5,8 mm, Mean LAWT was 1.36 ± 0.63 mm. Mean AI was 352 ± 36 on the RPVs and 356 ± 36 on the LPVs. Procedure time was 60,0 min (IQR 51-70). Fluoroscopy time was 58,5 s (35-97,5). First pass isolation was obtained in 72 (90%) of the RPVs and 75 (93,8%) of the LPVs. Conclusions the present study, assessing a novel, personalized protocol for radiofrequency titration during atrial fibrillation ablation, shows a high rate of first pass isolation with a lower need for RF energy delivery and lower procedure requirements, as compared to previous PV ablation protocols. Further studies are needed to evaluate the long-term results of this approach. Abstract Figure. LAWT-map Visitag points with tailored AI

Esophageal injury after atrial fibrillation ablation with an epicardial high-intensity focused ultrasound device

2011 ◽  
Vol 31 (3) ◽  
pp. 243-245 ◽  
Author(s):  
Narawudt Prasertwitayakij ◽  
Deepthi Vodnala ◽  
Ara K. Pridjian ◽  
Ranjan K. Thakur
Keyword(s):  
Atrial Fibrillation ◽  
High Intensity ◽  
Focused Ultrasound ◽  
High Intensity Focused Ultrasound ◽  
Atrial Fibrillation Ablation ◽  
Esophageal Injury ◽  
Ultrasound Device

scholarly journals B-PO04-116 ESOPHAGEAL TEMPERATURE DURING ATRIAL FIBRILLATION ABLATION POORLY PREDICTS ESOPHAGEAL INJURY: AN OBSERVATIONAL STUDY

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S326
Author(s):  
Tarek Ayoub ◽  
Abdel Hadi El Hajjar ◽  
Lilas Dagher ◽  
Gursukhman Deep Singh Sidhu ◽  
Nassir F. Marrouche
Keyword(s):  
Atrial Fibrillation ◽  
Observational Study ◽  
Atrial Fibrillation Ablation ◽  
Esophageal Injury ◽  
Esophageal Temperature

High‐power application is associated with shorter procedure time and higher rate of first‐pass pulmonary vein isolation in ablation index‐guided atrial fibrillation ablation

2019 ◽  
Vol 30 (12) ◽  
pp. 2751-2758 ◽  
Author(s):  
Hideharu Okamatsu ◽  
Junjiro Koyama ◽  
Yoshirou Sakai ◽  
Koudai Negishi ◽  
Katsuhide Hayashi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
High Power ◽  
Atrial Fibrillation Ablation ◽  
Procedure Time ◽  
Ablation Index ◽  
First Pass ◽  
Power Application

Canine Model of Esophageal Injury during Atrial Fibrillation Ablation

2011 ◽  
pp. 40-54
Author(s):  
Hiroshi Nakagawa ◽  
Atsushi Ikeda ◽  
Tushar Sharma ◽  
Jan V. Pitha ◽  
Warren M. Jackman
Keyword(s):  
Atrial Fibrillation ◽  
Canine Model ◽  
Atrial Fibrillation Ablation ◽  
Esophageal Injury
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