Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Experimental methods D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-160 - Greater Extent Of Mechanical Esophageal Deviation With A Newer Generation Esophageal Balloon Retractor (ID 475)


Background: Mechanical esophageal deviation (MED) allows for safe, uninterrupted ablation along the posterior left atrium (LA) during PVI. An inflatable balloon retractor (DV8, Manual Surgical Sciences Inc) has been shown able to safely perform MED.
Objective: To compare the extent of MED with the DV8 retractor in comparison to a newer generation, thinner DV8 device.
Methods: MED was performed to maximize the distance from the trailing esophageal edge to permit contralateral PVI. After MED using either the newer (11.9mm OD; Group A) or current (15.3mm OD; Group B) DV8 retractor, the CARTO3 mapping system (Biosense Webster Inc) was used to mark the trailing esophageal edge as seen by fluoroscopy in an AP view. After PVI, 3 measurements (superior, middle and inferior) were taken along the posterior LA between the esophagus and ablation line. Student’s t-tests were used to compare the extent of MED from the newer and older DV8 devices.
Results: Group A pts (n=9) underwent PVI of 16 vein pairs (right PVI=9, left PVI=7) with the newer DV8 device, and group B pts (n=14) underwent PVI of 28 vein pairs (right PVI=14, left PVI=14) with the older DV8 device. The overall extent of MED in group A (n=48, 26.9±2.5 mm) was significantly greater than in group B [(n=84, 19.3±1.73 mm), p<0.001]. Compared to group B, group A pts experienced a significantly greater extent of MED for both right PVI (31.2±2.9 mm vs 22.4±2.4 mm, p<0.001) and left PVI (21.3±2.9 mm vs 16.1±2.1 mm, p=0.007). There were no esophageal complications in any pts.
Conclusion: The newer generation DV8 device allows for a significantly greater extent of MED compared to the older generation DV8 device.