Ablation of atrial fibrillation and esophageal injury: Role of bipolar and unipolar energy using a novel multipolar irrigated ablation catheter

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Antonio Di MonacoMassimo Grimaldi

Abstract

The circular nMARQ ablation catheter is a useful tool for pulmonary vein isolation (PVI). Some studies reported a high incidence of esophageal lesions by using this catheter. The primary aim of this study was to compare the effects on the esophageal wall of bipolar and unipolar energy applied by the nMARQ ablation catheter during AF ablation. Forty patients (mean age 53 ± 8 years; 26 [65%] men) were enrolled to perform PVI for symptomatic atrial fibrillation. Thirty patients underwent PVI with the nMARQ catheter (group 1) and 10 patients with the ThermoCool Surround Flow catheter (group 2). The procedures were performed with the CARTO3 system. All patients received an esophageal temperature probe. In group 1, we delivered unipolar energy on the left posterior wall with power between 15 and 18 W or bipolar energy with power at 15 W. In group 2, unipolar energy was delivered on the posterior atrial wall at 20-25 W power. All patients underwent esophagoscopy the day after the procedure. No patients had procedural complications. In group 1, bipolar energy was associated with a lower esophageal temperature increase as compared with unipolar energy (0.6°C [range 0-2.2°C] vs 2.1°C [range 0.8-2.9°C]; P < .001). Unipolar energy was asso...Continue Reading

References

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Citations

Jan 14, 2016·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·Reza WakiliHeidi L Estner
Jun 30, 2016·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·Philipp HalbfassThomas Deneke
Aug 7, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jacob S KoruthVivek Y Reddy
Nov 4, 2016·Expert Review of Medical Devices·Lucila Rey-AresFederico Augustovski
Dec 19, 2017·Journal of Atrial Fibrillation·Avishag Laish-Farkash, Mahmoud Suleiman
Jun 19, 2018·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·Francis J HaHan S Lim

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