Shorter distance between the esophagus and the left atrium is associated with higher rates of esophageal thermal injury after radiofrequency ablation.
Shorter distance between the esophagus and the left atrium is associated with higher rates of esophageal thermal injury after radiofrequency ablation.
复制标题
食管与左心房之间的距离越短，射频消融后食管热损伤发生率越高。
DOI：
10.1111/jce.15554
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发表时间：
2022-07
影响因子：
2.7
通讯作者：
Ranjan, Ravi
中科院分区：
文献类型：
--
作者：
Ishidoya, Yuki;Kwan, Eugene;Dosdall, Derek J.;Macleod, Rob S.;Navaravong, Leenhapong;Steinberg, Benjamin A.;Bunch, T. Jared;Ranjan, Ravi
关键词：
食管热损伤（ETI）是房颤导管消融术的已知潜在严重并发症。我们的目的是评估食管与左心房后壁（LAPW）之间的距离及其与食管热损伤的关系。回顾性分析了73例在LA射频导管消融治疗症状性房颤后接受食管胃镜检查（EGD）和消融前磁共振成像（MRI）的患者，以确定食管内腔与消融心房内膜之间的最小距离（消融前心房食管距离; pre-AED）和ETI的发生率。从CARTO 3系统中收集30例患者的消融指数参数（AI，Visitag Surpoint），并进行比较，以评估消融策略和AI是否进一步影响ETI风险。无ETI患者的AED前值显著大于ETI患者（5.23 ± 0.96 mm vs 4.31 ± 0.75 mm，p < 0.001）。AED前显示预测ETI的准确性较高，最佳截止值为4.37 mm。在低功率长时间消融组中，消融后MRI检测到的Visitag病变标记物伴或不伴食管晚期钆增强（LGE）之间的AI具有统计学可比性（LPLD，25- 40 W，持续10 - 30 s，393.16 [308.62，408.86] vs 406.58 [364.38，451.22]，p = 0.16）和高功率短时组（HPSD，50 W持续5-10秒，336.14 [299.66，380.11] vs 330.54 [286.21，384.71]，p = 0.53）。在消融前LGE-MRI中测量LA与食管之间的距离有助于预测LAPW消融后的ETI。
Esophageal thermal injury (ETI) is a known and potentially serious complication of catheter ablation for atrial fibrillation. We intended to evaluate the distance between the esophagus and the left atrium posterior wall (LAPW) and its association with esophageal thermal injury. A retrospective analysis of 73 patients who underwent esophagogastroduodenoscopy (EGD) after LA radiofrequency catheter ablation for symptomatic atrial fibrillation and pre-ablation magnetic resonance imaging (MRI) was used to identify the minimum distance between the inner lumen of the esophagus and the ablated atrial endocardium (pre-ablation atrial esophageal distance; pre-AED) and occurrence of ETI. Parameters of ablation index (AI, Visitag Surpoint) were collected in 30 patients from the CARTO3 system and compared to assess if ablation strategies and AI further impacted risk of ETI. Pre-AED was significantly larger in patients without ETI than those with ETI (5.23 ± 0.96 mm vs 4.31 ± 0.75 mm, p < 0.001). Pre-AED showed high accuracy for predicting ETI with the best cutoff value of 4.37 mm. AI was statistically comparable between Visitag lesion markers with and without associated esophageal late gadolinium enhancement (LGE) detected by post-ablation MRI in the low-power long-duration ablation group (LPLD, 25–40W for 10 to 30 s, 393.16 [308.62, 408.86] versus 406.58 [364.38, 451.22], p = 0.16) and high-power short-duration group (HPSD, 50W for 5–10 s, 336.14 [299.66, 380.11] versus 330.54 [286.21, 384.71], p = 0.53), respectively. Measuring the distance between the LA and the esophagus in pre-ablation LGE-MRI could be helpful in predicting ETI after LAPW ablation.
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影响因子：
5.5
作者：
Yarlagadda, Bharath;Deneke, Thomas;Lakkireddy, Dhanunjaya
通讯作者：
Lakkireddy, Dhanunjaya
DOI：
10.1093/europace/eux275
发表时间：
2018-01-01
期刊：
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
影响因子：
--
作者：
Calkins H;Hindricks G;Cappato R;Kim YH;Saad EB;Aguinaga L;Akar JG;Badhwar V;Brugada J;Camm J;Chen PS;Chen SA;Chung MK;Nielsen JC;Curtis AB;Davies DW;Day JD;d'Avila A;de Groot NMSN;Di Biase L;Duytschaever M;Edgerton JR;Ellenbogen KA;Ellinor PT;Ernst S;Fenelon G;Gerstenfeld EP;Haines DE;Haissaguerre M;Helm RH;Hylek E;Jackman WM;Jalife J;Kalman JM;Kautzner J;Kottkamp H;Kuck KH;Kumagai K;Lee R;Lewalter T;Lindsay BD;Macle L;Mansour M;Marchlinski FE;Michaud GF;Nakagawa H;Natale A;Nattel S;Okumura K;Packer D;Pokushalov E;Reynolds MR;Sanders P;Scanavacca M;Schilling R;Tondo C;Tsao HM;Verma A;Wilber DJ;Yamane T
通讯作者：
Yamane T
影响因子：
37.8
作者：
Cummings, JE;Schweikert, RA;Natale, A
通讯作者：
Natale, A
影响因子：
5.5
作者：
Calkins, Hugh;Hindricks, Gerhard;Yamane, Teiichi
通讯作者：
Yamane, Teiichi
DOI：
10.1111/j.1540-8167.2007.00879.x
发表时间：
2007-06-01
影响因子：
2.7
作者：
Marrouche, Nassir F.;Guenther, Jens;Brachmann, Johannes
通讯作者：
Brachmann, Johannes