Abstract 15872: Safety and Efficacy of Catheter Ablation of Atrial Fibrillation Using an Esophageal Temperature Monitoring in the Patients with a Small BMI
INTRODUCTION: Esophageal injury following catheter ablation of atrial fibrillation is reported to occur in up to 35% of patients. Even with a low energy setting (20-25W), the lesion occurs in 10%. The BMI is reported to be a predictor of esophageal injury.
HYPOTHESIS: Radiofrequency ablation (RF) with a lower energy setting 20W controlled by esophageal temperature monitoring with a lower setting with 39°C can prevent esophageal injury even in the patients with a smaller BMI.
METHODS: This prospective study compared two groups: GroupI : < BMI 24 (per 1kg / m2) in 15 patients, Group II: ≥ 24 (per 1kg / m2) in 15. If esophageal temperature monitored by esophageal temperature probe (Sensi Therm, St. Jude Medical) exceeded 39°C, RF application was stopped immediately. RF application could be performed in a fashion of ‘point by point’ with a maximum 20 seconds. Endoscopy was performed in 1or 2 days postablation.
RESULTS: The mean BMI was measured as 22 ± 1.8 (per 1kg / m2) in Group I and 26 ± 1.8 (per 1kg / m2) in Group II. The esophagus was closer to the posterior wall of left atrium in Group I compared to Group II (1.1 ± 0.3mm in Group I, 1.7 ± 0.7mm in Group II, p = 0.008, respectively). Nevertheless, There were no significant differences in the maximum esophageal temperature and the incidence of temperature rise >39°C between two groups (40.1 ± 0.2°C v.s. 40.7 ± 0.2 °C, p = 0.077; 3.4 ± 2.8 v.s. 4.9 ± 2.7, p = 0.172, respectively), resulting in no occurrence of esophageal injury in both Group I and II.
CONCLUSION: RF ablation with a low energy setting 20W, strictly controlled by esophageal temperature monitoring with a low setting with 39°C may contribute to increase the safety profile in catheter ablation of left atrium, even in the patients with a smaller BMI.
- © 2012 by American Heart Association, Inc.