Oesophageal cooling with ice water does not reduce the incidence of oesophageal lesions complicating catheter ablation of atrial fibrillation: randomized controlled study

• DOI: 10.1093/europace/eut368
• Publication Date: 2014-01-28T01:35:07Z
• Authors: T. Kuwahara; A. Takahashi; K. Okubo; K. Takagi; K. Yamao; E. Nakashima; N. Kawaguchi; M. Takigawa; Y. Watari; T. Sugiyama; K. Handa; S. Kimura; H. Hikita; A. Sato; K. Aonuma
• Keywords: Male; Incidence; Ice; Middle Aged; Esophageal Diseases; Combined Modality Therapy; Risk Assessment; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Hypothermia, Induced; Atrial Fibrillation; Catheter Ablation; Humans; Female; Therapeutic Irrigation

Atrial fibrillation (AF) ablation can result in oesophageal injuries that lead to atrio-oesophageal fistulae, a life-threatening complication. This study aimed evaluate whether cooling could prevent lesions complicating AF ablation.We randomly assigned 100 patients with drug-resistant an group or control group. In the group, we injected 5 mL of ice water into oesophagus prior radiofrequency (RF) energy delivery adjacent oesophagus. If temperature reached 42°C, RF was stopped, and injection repeated. not applied. Oesophageal endoscopy performed 1 day after catheter ablation, were qualitatively assessed as mild, moderate, severe. The numbers sites >42°C 1.7 ± 1.4 2.6 respectively (P = 0.04), maximal at those 43.0 0.6 44.7 0.9°C < 0.0001). occurred almost equally between [10 50 (20%)] [11 (22%)]. However, severity slightly milder (three seven mild) than severe, one mild).Oesophageal may alleviate but does reduce incidence this complication under specific protocol evaluated here.