Effect of Catheter Ablation Procedural Volume on Atrioesophageal Fistula Rate Reduction After Adoption of Proactive Esophageal Cooling During Atrial Fibrillation Ablation
Document Type
Conference Proceeding
Publication Date
5-2024
Publication Title
Heart Rhythm
Abstract
Background: In contrast to luminal esophageal temperature (LET) monitoring, proactive esophageal cooling has been shown to significantly reduce the incidence of atrioesophageal fistula (AEF) formation after radiofrequency (RF) catheter ablation for the treatment of atrial fibrillation. The effect of lab catheter ablation procedural volume on AEF rate and the reduction of this rate with proactive esophageal cooling has not been examined. Objective: We aimed to investigate the effect of monthly lab procedural volume on the impact of AEF rate and AEF rate reduction in a large real-world data set. Methods: We analyzed data from a 25-center study of the number of AEFs occurring in equivalent time frames before and after adoption of a dedicated esophageal cooling device (ensoETM, Attune Medical). The effect of procedural volume on AEF rate and AEF rate reduction was quantified using generalized estimating equations with a linear model of AEF incidence on (1) the use of cooling, (2) hospital procedural volume, and (3) their interaction, with an independent working correlation. Results: A total of 25,186 patients were treated over the analysis period. The AEF rate was reduced from 16 out of 10,962 patients treated with LET monitoring (0.146%) to 0 out of 14,224 patients treated with active esophageal cooling (P , 0.0001). Monthly procedural volume ranged from 6 to 44 across the 25 hospital systems. The AEF rate using LET monitoring was not associated with lab procedural volume, and the AEF rate after adopting esophageal cooling was significantly reduced across the entire range of procedural volume (Figure 1). Conclusion: AEF rate was independent of lab procedural volume using LET monitoring, and the reduction in AEF rate after adopting proactive esophageal cooling was significant regardless of lab procedural volume.
Volume
21
Issue
5S
First Page
S86
Last Page
S87
Recommended Citation
Sanchez JE, Woods C, Zagrodzky JD, Nazari J, Singleton M, Schricker A, et al. [Zahwe F]. Effect of catheter ablation procedural volume on atrioesophageal fistula rate redcution after adoption of proactive esophageal cooling during atrial fribrillation ablation. Heart Rhythm. 2024 May; 21(5S):S86-S87. doi: 10.1016/j.hrthm.2024.03.433
DOI
10.1016/j.hrthm.2024.03.433
Comments
Heart Rhythm Society Annual Meeting, May 16-19, 2024, Boston, MA