Prevalence and characteristics of asymptomatic excessive transmural injury after radiofrequency catheter ablation of atrial fibrillation

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

“…In their series of more than 1500 procedures with temperature probes placed in the esophagus, however, fatal atrio-esophageal fistula occurred in 1 patient without a documented significant temperature increase during the ablation procedure. A recent multivariate analysis comparing data from patients with and without esophageal lesions revealed that patients with a BMI o26 displayed an increased risk for esophageal injury [12]. The incidence of esophageal injury after AF ablation has been described previously and varied among studies.…”

“…To avoid this complication, esophageal temperature probes, inserted nasally and advanced to the level of the left atrium (LA) under fluoroscopic guidance, are used to mark the location of the esophageal lumen and permit real-time intraluminal esophageal temperature monitoring (ETM) during ablation [9][10][11]. Furthermore, body mass index (BMI) has been reported to be a predictor of esophageal injury, indicating that patients with a lower BMI (o24.9) are at a higher risk [12]. However, the incidence of esophageal injury in patients with a low BMI has not been well scrutinized.…”

Efficacy and Safety of Periprocedural Dabigatran in Patients Undergoing Catheter Ablation of Atrial Fibrillation

“…15 After a transseptal catheterization, two 7-Fr decapolar ring catheters (Lasso, Biosense Webster, Diamond Bar, CA, USA) and a 7.5-Fr irrigation catheter with a 3.5-mm distal electrode (Thermocool, Biosense Webster) were inserted into the left atrium (LA). The right-sided and leftsided circular lesions encircling the ipsilateral pulmonary veins …”

Low Incidence of Esophageal Lesions After Pulmonary Vein Isolation Using Contact-Force Sensing Catheter Without Esophageal Temperature Probe

“…However a lower BMI was been shown to be a predictor for the development of esophageal injury. 21) For ablating physicians, the prevention of EDEL and AEF is essential. Knowledge of the left atrial anatomy and thoughtful ablation at the posterior left atrial wall with reduced power setting may contribute to a safe and successful PVI.…”