Waqas Kayani, Amir A Schricker, Ridhima Nerlekar, Brooke Earnest, Richard Hongo, Steven Hao, Christopher Woods
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Esophageal cooling vs luminal esophageal temperature monitoring in high-power short-duration ablation of paroxysmal atrial fibrillation.
Background: Treatment of PAF with PVI is the gold standard approach. Recently, esophageal cooling has been shown to significantly reduce the risk of esophageal injury during thermal ablation. This study investigated outcomes of HPSD before and after instituting esophageal cooling.
Methods: In this natural experiment, we enrolled 346 consecutive patients with PAF undergoing initial ablation using HPSD, 143 patients immediately prior to and 203 patients immediately after switching from luminal esophageal monitoring (LET arm) to esophageal cooling with ensoETM (ensoETM arm). The primary endpoint was time-to-atrial arrhythmia recurrence.
Results: The procedure times were significantly faster with ensoETM (82.9 ± 27 vs 112 ± 49 min, p < 0.0001). At a median follow-up of 10.3 ± 3.4 months, the atrial arrhythmia recurrence rate did not significantly differ between LET and ensoETM arms (25.2% vs 30.0%, p = 0.3202). Kaplan-Meier analysis showed no significant difference in the overall atrial arrhythmia recurrence (log-rank, p = 0.3780). Statistical analysis of all notable comorbidities revealed no significant association with procedural outcomes.
Conclusion: In patients with PAF undergoing an initial ablation procedure with HPSD, esophageal cooling led to significantly faster procedures, with no decrease in efficacy.
期刊介绍：
The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.
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