Active esophageal cooling during radiofrequency ablation of the left atrium: data review and update.
Active esophageal cooling during radiofrequency ablation of the left atrium: data review and update.
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DOI：
10.1080/17434440.2022.2150930
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发表时间：
2022-12
影响因子：
3.1
通讯作者：
Daniels, James
中科院分区：
文献类型：
--
作者：
Cooper, Julie;Joseph, Christopher;Zagrodzky, Jason;Woods, Christopher;Metzl, Mark;Turer, Robert W.;McDonald, Samuel A.;Kulstad, Erik;Daniels, James
关键词：
心脏左心房的射频消融越来越多地用于治疗心房颤动（AF）。不幸的是，在此过程中可能会发生对食管的意外热损伤，可能会造成80%致命的心房食管瘘（AEF）。ensoETM（Attune Medical，芝加哥，IL）是一种食管冷却器械，已证明可减少射频消融期间对食管的热损伤。本文综述了射频消融治疗房颤过程中主动食管冷却相关的越来越多的证据。综述提供的数据表明，与患者安全性和手术效率相关的结局有所改善，并为未来的研究提出了方向。在射频消融过程中使用主动食管冷却可减少食管损伤，减少或消除透视要求，缩短手术时间和术后疼痛，并长期避免心律失常。这些影响反过来又增加了患者当天出院率，降低了操作员的认知负荷，并降低了成本。这些发现可能会进一步加速主动食管冷却的采用。房颤是一种心脏不规则跳动的疾病，会引起心悸、头晕、呼吸急促和胸痛等症状。房颤会增加中风、心力衰竭、痴呆和死亡的风险。心房颤动的一种治疗方法是导管消融术。这个过程是微创的，由一个专门的心脏病专家，称为电生理学家。电生理学家或操作员使用能量源，如射频能量（无线电波），以阻止不稳定的电信号通过心脏。导管消融术的一个并发症是对食道的意外损伤，食道是将食物从口腔传递到胃的器官。如果损伤严重，可能会发展成心房食管瘘，这通常会导致死亡。在这篇综述中，描述了一种新技术，有助于防止这种类型的伤害，并可以为患者，操作员和医院提供额外的好处。
Radiofrequency (RF) ablation of the left atrium of the heart is increasingly used to treat atrial fibrillation (AF). Unfortunately, inadvertent thermal injury to the esophagus can occur during this procedure, potentially creating an atrioesophageal fistula (AEF) which is 80% fatal. The ensoETM (Attune Medical, Chicago, IL), is an esophageal cooling device that has been shown to reduce thermal injury to the esophagus during RF ablation. This review summarizes growing evidence related to active esophageal cooling during RF ablation for the treatment of AF. The review presents data demonstrating improved outcomes related to patient safety and procedural efficiency and suggests directions for future research. The use of active esophageal cooling during RF ablation reduces esophageal injury, reduces or eliminates fluoroscopy requirements, reduces procedure duration and post-operative pain, and increases long-term freedom from arrhythmia. These effects in turn increase patient same-day discharge rates, decrease operator cognitive load, and reduce cost. These findings are likely to further accelerate adoption of active esophageal cooling. Atrial fibrillation is a condition in which the heart beats irregularly, causing symptoms such as palpitations, dizziness, shortness of breath, and chest pain. Atrial fibrillation increases the risk for stroke, heart failure, dementia, and death. One treatment for atrial fibrillation is a procedure called a catheter ablation. This procedure is minimally invasive and is performed by a specialized cardiologist, called an electrophysiologist. The electrophysiologist, or operator, uses an energy source, such as radiofrequency energy (radio waves), to stop erratic electrical signals from traveling through the heart. One complication of the catheter ablation is an inadvertent injury to the esophagus, the organ that passes food from the mouth to the stomach. If the injury is severe it may develop into an atrioesophageal fistula, which often results in death. In this review a new technology is described that helps prevent this type of injury and can provide additional benefits for the patient, operator, and hospital.
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影响因子：
--
作者：
Aycock, Kenneth N.;Campelo, Sabrina N.;Davalos, Rafael, V
通讯作者：
Davalos, Rafael, V
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：
3.5
作者：
Berjano, EJ;Hornero, F
通讯作者：
Hornero, F
影响因子：
2.8
作者：
Aksu, Tolga;Golcuk, Sukriye;Erden, Ismail
通讯作者：
Erden, Ismail
影响因子：
5.5
作者：
Chen, Shaojie;Schmidt, Boris;Chun, K. R. Julian
通讯作者：
Chun, K. R. Julian