Ilya SorokinPrivolzhsky District Medical Centre of the Federal Medical and Biological Agency , Russian Federation
Title: Esophageal Temperature Management During Cryoballoon Ablation For Atrial Fibrillation, a New Method
The problem of oesophageal injury during cryoballoon ablation (CBA) for atrial fibrillation (AF) appears to be significant. One of the complications is atrio-esophageal fistula with high mortality rates. The main reason for oesophageal injury is low luminal esophageal temperature (LET) during cryoablation. There are some methods offered to manage LET. One of them is termination of ablation in case of 20°C LET. The other method is esophagus deviation with special device, but it does not evaluated for CBA. And the third method could be consisted in warming through special tubes in esophagus, but it was not effective in pilot study. We offer a new method for managing LET during CBA. The principle of this method is special inverse ratio breathing pattern. We perform prospective experimental study to evaluate this method in 59 patients with low LET of 149 patients of our daily practice. There was two groups: 34 patients in experimental and 15 in control. There was longer ablation time in experimental group 194 [±50] seconds and it was close to planned ablation time (240 seconds) rather in control group 144 [±44] seconds (p=.001). There was no difference in esophageal lesion between two groups. We find out that our method could be useful for managing LET during cryoapplication in left superior pulmonary vein and right superior pulmonary vein. In left inferior pulmonary vein usefulness of our method is low.
Ilya Sorokin is an interventional cardiologist since 2012. In 2017 he started to study electrophysiology and from 2019 was interested in catheter ablation for atrial fibrillation. To the date, there is 5 publications in cardiology and 2 of them in electrophysiology. Since 2019 he is involved in problem of esophageal injury during cryoballoon ablation for atrial fibrillation.