Incidence of esophageal injury after pulmonary vein isolation in patients with a low body mass index and esophageal temperature monitoring at a 39 °C setting.
BACKGROUND
Esophageal injury following catheter ablation of atrial fibrillation (AF) is reported to occur in 35% of patients. Even with a low energy setting (20-25 W), lesions develop in 10% of patients. Body mass index (BMI) has been reported to be a predictor of esophageal injury, indicating that patients with a low BMI (<24.9 kg/m(2)) are at a higher risk. We hypothesized that catheter ablation with a lower energy setting of 20 W controlled by esophageal temperature monitoring (ETM) at 39 °C could prevent esophageal injury even in patients with a BMI <24.9 kg/m(2).


METHODS
Twenty patients with AF were included (age, 63±8 years; BMI, 22.9±1.3 kg/m(2), left atrium diameter, 44±11 mm). If the esophageal temperature probe registered a temperature of >39 °C, radiofrequency (RF) application was stopped immediately. RF application could be performed in a "point by point" manner for a maximum of 20 s. Endoscopy was performed 1-5 days after ablation.


RESULTS
Esophageal mucosal injury was not observed in any patient in the study.


CONCLUSIONS
Catheter ablation using ETM reduced the incidence of esophageal injuries, even in patients with a low BMI.
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Kunihiko
K
Kiuchi
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Katsunori
K
Okajima
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Akira
A
Shimane
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Gaku
G
Kanda
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Kiminobu
K
Yokoi
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Jin
J
Teranishi
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Kousuke
K
Aoki
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Misato
M
Chimura
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Hideo
H
Tsubata
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Taishi
T
Miyata
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Yuuki
Y
Matsuoka
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Takayoshi
T
Toba
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Shogo
S
Ohishi
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Takahiro
T
Sawada
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Yasue
Y
Tsukishiro
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Tetsuari
T
Onishi
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Seiichi
S
Kobayashi
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Yasuyo
Y
Taniguchi
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Shinichiro
S
Yamada
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Yoshinori
Y
Yasaka
Department of Cardiology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Hiroya
H
Kawai
Department of Gastroenterology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Takashi
T
Harada
Department of Gastroenterology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Masato
M
Ohsawa
Department of Gastroenterology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Yasutomo
Y
Azumi
Department of Gastroenterology, Himeji Cardiovascular Center, Saishyo kou 520, Himeji, Hyogo, Japan.
Mitsuharu
M
Nakamoto
AF, atrial fibrillation; Atrial fibrillation; BMI, body mass index; Esophageal injury; Pulmonary vein isolation; RF, radiofrequency