Abstract | OBJECTIVES: BACKGROUND: Ablation along the posterior left atrium may cause an atrioesophageal fistula. One strategy for avoiding this risk is to not deliver radiofrequency energy at sites in contact with the esophagus. METHODS: In 51 consecutive patients with atrial fibrillation who underwent left atrial ablation under conscious sedation, digital cine-fluoroscopic imaging of the esophagus was performed in two views after ingestion of barium paste at the beginning and end of the ablation procedure. Movement of the esophagus was determined at the superior, mid-, and inferior parts of the posterior left atrium in reference to the spine. RESULTS: Mean esophageal movement was 2.0 +/- 0.8 cm (range = 0.3 to 3.8 cm) at the superior, 1.7 +/- 0.8 cm (range = 0.1 to 3.5 cm) at the mid-, and 2.1 +/- 1.2 cm (range = 0.1 to 4.5 cm) at the inferior levels. In 67% of the 51 patients, the esophagus shifted by > or =2 cm, and in 4% there was > or =4 cm of lateral movement. The mean change in esophageal luminal width was 5 +/- 7 mm (range = 0 to 36 mm) at the superior, 5 +/- 7 mm (range = 0 to 32 mm) at the mid-, and 6 +/- 7 mm (range = 0 to 21 mm) at the inferior levels of the posterior left atrium. CONCLUSIONS:
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Authors | Eric Good, Hakan Oral, Kristina Lemola, Jihn Han, Kamala Tamirisa, Petar Igic, Darryl Elmouchi, David Tschopp, Scott Reich, Aman Chugh, Frank Bogun, Frank Pelosi Jr, Fred Morady |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 46
Issue 11
Pg. 2107-10
(Dec 06 2005)
ISSN: 1558-3597 [Electronic] United States |
PMID | 16325049
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Atrial Fibrillation
(surgery)
- Catheter Ablation
(adverse effects)
- Conscious Sedation
- Esophageal Fistula
(etiology)
- Esophagus
(physiopathology)
- Female
- Fistula
(etiology)
- Fluoroscopy
- Heart Atria
- Heart Diseases
(etiology)
- Humans
- Male
- Middle Aged
- Movement
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