Document Detail

Prevalence and Characteristics of Asymptomatic Excessive Transmural Injury Following Radiofrequency Catheter Ablation of Atrial Fibrillation.
MedLine Citation:
PMID:  21315839     Owner:  NLM     Status:  Publisher    
BACKGROUND: Even with a low energy setting, radiofrequency energy applications on the left atrial (LA) posterior wall may cause excessive transmural injury (ETI) during catheter ablation of atrial fibrillation (AF). OBJECTIVE: The purpose of this study was to clarify the prevalence and characteristics of ETI. METHODS: This study included 104 patients with AF who underwent extensive encircling pulmonary vein isolation (EEPVI) followed by an endoscopic examination (≤48 hours after EEPVI). EEPVI was performed under conscious sedation and the ablation settings at the LA posterior wall were a maximum energy of 20-25 W and duration of ≤30 sec. The ETI was defined as any injury that resulted from EEPVI including esophageal damage or peri-esophageal nerve injury. RESULTS: ETIs were found in 10 (9.6%) patients and were all asymptomatic; esophageal damage in 4 patients and peri-esophageal nerve injury in the remaining 6. All patients with ETI were below normal weight (body mass index [BMI]<24.9 kg/m(2)), and consisted of 17% of those below normal weight. The procedural parameters such as the type of energy source, total duration of energy applications to the LA posterior wall, additional LA linear ablation and biochemical markers were not related to the ETI. In the logistic multi-adjusted model, the BMI (per 1 kg/m(2)) was the only independent predictor of ETI (odds ratio=0.76; 95% confidence interval=0.59-0.97, p<0.05). CONCLUSIONS: Asymptomatic ETIs were not rare even with a low energy setting in patients below normal weight. Tailored energy settings based on the patient's BMI may be required when performing EEPVI.
Hiro Yamasaki; Hiroshi Tada; Yukio Sekiguchi; Miyako Igarashi; Takanori Arimoto; Takeshi Machino; Mahito Ozawa; Yoshihisa Naruse; Kenji Kuroki; Hidekazu Tsuneoka; Yoko Ito; Nobuyuki Murakoshi; Keisuke Kuga; Ichinosuke Hyodo; Kazutaka Aonuma
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-9
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Cardiovascular Division, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
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