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Esophageal position, measured luminal temperatures, and risk of atrioesophageal fistula with atrial fibrillation ablation
- Source :
- Pacing and Clinical Electrophysiology. 42:458-463
- Publication Year :
- 2019
- Publisher :
- Wiley, 2019.
-
Abstract
- BACKGROUND Despite improvement in catheter ablation for atrial fibrillation (AF), ability to recognize and prevent esophageal injury remains challenging. We hypothesized that esophageal course may impact esophageal heating, as measured through ablation, and thereby, risk of injury. METHODS We evaluated all patients undergoing first-time AF ablation with preprocedural computed tomography (CT) imaging from 2014 to 2016 at our institution, focusing on esophageal position at the left atrial (LA)/pulmonary vein junction. Esophageal luminal temperatures (ELTs) were analyzed by esophageal course. In exploratory work by investigation of published reports of atrioesophageal fistula (AEF), we evaluated for a relationship between esophageal course and risk of AEF. RESULTS Of 68 patients, 48.5% had midline, 36.8% leftward, and 14.7% rightward esophageal positions. Of 20 patients (29% of cohort) with esophageal confinement-defined as a midline or leftward position relative to the LA, vertebrae, and aorta, with luminal distortion-14 had leftward position. No significant differences in patient or procedure characteristics were noted between confinement and nonconfinement cohorts. The average peak ELT was significantly higher in those with confinement (36.9°C vs 36.2°C, P
- Subjects :
- Male
medicine.medical_specialty
Hot Temperature
medicine.medical_treatment
Catheter ablation
030204 cardiovascular system & hematology
Pulmonary vein
Esophageal Fistula
03 medical and health sciences
Esophagus
0302 clinical medicine
Internal medicine
medicine.artery
Atrial Fibrillation
medicine
Humans
Heart Atria
030212 general & internal medicine
Risk factor
Aorta
business.industry
Atrial fibrillation
General Medicine
Middle Aged
medicine.disease
Ablation
medicine.anatomical_structure
Catheter Ablation
Cardiology
Female
Tomography, X-Ray Computed
Cardiology and Cardiovascular Medicine
business
Ablation zone
Subjects
Details
- ISSN :
- 15408159 and 01478389
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Pacing and Clinical Electrophysiology
- Accession number :
- edsair.doi.dedup.....7eeafe5426b1b285a20ebeb8ba722d52