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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >The influence of cryoballoon manipulation on luminal esophageal temperature during ablation for atrial fibrillation
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The influence of cryoballoon manipulation on luminal esophageal temperature during ablation for atrial fibrillation

机译：冷冻机操纵对心房颤动期间腔食管温度的影响

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摘要

Abstract Background Esophageal injury is related to a reduction in luminal esophageal temperature (LET) in second‐generation cryoballoon (CB) ablation; however, methods to prevent these reductions in temperature have not been well characterized. Methods Esophageal temperature was continuously monitored using a LET probe in patients undergoing pulmonary vein (PV) isolation using the second‐generation CB. A rotational maneuver of the CB was performed if the initial ablation resulted in a decrease of more than 4°C in LET. The refrigerant injector near the distal CB pole was used as a fluoroscopic marker to measure the nearest distance between the CB and the LET probe. Results A total of 52 consecutive patients were enrolled in this study. The rotation was applied in 19 patients and 20 PVs (seven left superior pulmonary veins [LSPVs], seven left inferior PVs [LIPVs], and six right inferior PVs [RIPVs]) with a reduction in LET of more than 4°C during freezing. The nadir temperature of CB applications was similar before and after CB rotation in all PVs. There was significant difference in the minimum LET before and after rotation during freezing in LSPVs (28.4?±?3.7?vs 32.4?±?2.3°C, P ?=?.02), LIPVs (28.4?±?1.4?vs 32.6?±?2.7, P ?=?.01) and RIPVs (26.1?±?4.3?vs 34.0?±?1.3°C, P ?=?.002). The differences in mean balloon to LET distance were measured for all veins before and after rotation; LSPV (right anterior oblique [RAO], 11.0?±?1.7?vs 13.8?±?4.5?mm, P ?=?.05); LIPV (RAO, 10.7?±?4.3?vs 14.6?±?6.1?mm, P ?=?.03); RIPV (LAO, 11.8?±?5.5?vs 14.2?±?5.7?mm, P ?=?.01). Conclusions CB rotational maneuvers during ablation can prevent significant reduction in LET and may prevent esophageal injury during the procedure.
机译：摘要背景食管损伤与第二代冷冻（CB）消融中的腔食管温度（Let）的降低有关;然而，防止这些温度减少的方法并未得到很好的表征。方法使用第二代CB经历肺静脉（PV）分离的患者的令探针连续监测食管温度。如果初始消融导致在Let的降低超过4°C，则执行CB的旋转操纵。远端CB杆附近的制冷剂注射器用作荧光镜标记物，以测量Cb和允许探针之间的最近距离。结果共有52名连续患者参加本研究。旋转应用于19名患者和20个PVS（七个左上级肺静脉[LSPVS]，七个左下PVS [LIPVS]，六个右下PVS [RIPVS]），在冻结期间减少超过4°C 。在所有PV中的CB旋转之前和之后，CB应用的Nadir温度类似。在LSPV冻结期间旋转之前和旋转之前和之后的最小值有显着差异（28.4？±3.7？与32.4？±α≤2.3°C，p？=β.02），LIPVS（28.4？±？1.4？与32.6 ？±2.7，p？=？01）和RIPvs（26.1？±4.3？vs 34.0？±α？1.3°C，p？= 002）。在旋转之前和之后的所有静脉测量所有静脉的平均气球的差异; LSPV（右前斜[Rao]，11.0？±？1.7？Vs 13.8？±α？4.5？mm，p？= 05）; LIPV（RAO，10.7？±4.3？VS 14.6？±6.1？mm，p？=？03）; RIPV（老挝，11.8？结论CB在消融期间的旋转机动可以防止允许的显着减少，并且可以防止手术过程中的食管损伤。

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  • 作者

    Chen Hongwu; Liu Qiang; Shehata Michael; Ma Wei; Xu Jing; Cao Jianing; Cingolani Eugenio; Ehdaie Ashkan; Jiang Chenyang; Chen Minglong; Chugh Sumeet S.; Wang Xunzhang;

  • 作者单位

    Smidt Heart InstituteCedars Sinai Medical CenterLos Angeles California;

    Smidt Heart InstituteCedars Sinai Medical CenterLos Angeles California;

    Smidt Heart InstituteCedars Sinai Medical CenterLos Angeles California;

    Smidt Heart InstituteCedars Sinai Medical CenterLos Angeles California;

    Smidt Heart InstituteCedars Sinai Medical CenterLos Angeles California;

    Smidt Heart InstituteCedars Sinai Medical CenterLos Angeles California;

    Smidt Heart InstituteCedars Sinai Medical CenterLos Angeles California;

    Smidt Heart InstituteCedars Sinai Medical CenterLos Angeles California;

    Department of Cardiology Sir Run Run Shaw Hospital School of MedicineZhejiang UniversityHangzhou;

    Cardiology Divisionthe First Affiliated Hospital of Nanjing Medical UniversityNanjing Jiangsu PR;

    Smidt Heart InstituteCedars Sinai Medical CenterLos Angeles California;

    Smidt Heart InstituteCedars Sinai Medical CenterLos Angeles California;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 诊断学;
  • 关键词

    atrial fibrillation; cryoballoon; esophagus; pulmonary vein;

    机译：心房颤动;哭泣;食道;肺静脉;

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