Von Bary, Christian and Dornia, Christian and Kirchner, Gabriele and Weber, Stefan and Fellner, Claudia and Nisenbaum, David and Georgieva, Martina and Stroszczynski, Christian and Hamer, Okka W. (2013) Esophageal Tissue Injury Following Pulmonary Vein Isolation Using the PVAC: Assessment by Endoscopy and Magnetic Resonance Imaging. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 36 (4). pp. 477-485. ISSN 0147-8389, 1540-8159
Full text not available from this repository. (Request a copy)Abstract
Background We investigate the frequency of esophageal tissue injury (ETI) following ablation of atrial fibrillation (AF) using the pulmonary vein ablation catheter (PVAC) ascertained by esophageal endoscopy (ESE) and corresponding magnetic resonance imaging (MRI). Methods A total of 41 patients with symptomatic AF presenting for pulmonary vein isolation (PVI) were included consecutively in two observational groups. Group A received MRI the day before and ESE plus MRI within 34 weeks following the ablation procedure using the PVAC. Group B received MRI the day before and ESE plus MRI within 2 days after PVI. MRI included T2-weighted and T1-weighted postcontrast with fat suppression (fs) and late-enhancement scans to demonstrate postprocedural edema and contrast enhancement of the esophageal wall. Results A total of 13 (32%) patients were enrolled in Group A (26 +/- 11 days post-PVI), and 28 (68%) patients in Group B (2 +/- 0.6 days post-PVI). ETI was found by ESE in one (2%) patient (Group B) and resolved under conservative therapy. Corresponding MRI showed a false negative result with no alterations of esophageal structures using T1-weighted, T2-weighted, and late enhancement scans. In addition, false positive results were demonstrated by late-enhancement MRI in five (12%) patients (three patients in Group A and two patients in Group B), which could not be verified by corresponding ESE. Conclusions Endoluminal ETI is a rare but possible complication, which should be considered following PVAC procedures. MRI of the esophagus is currently not a reliable screening method due to false positive and negative findings compared to ESE. (PACE 2013; 36:477-485)
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RADIOFREQUENCY CATHETER ABLATION; ATRIAL-FIBRILLATION ABLATION; LESIONS; TEMPERATURE; PREVALENCE; TIME; atrial fibrillation; phased RF ablation; esophageal injury; esophageal fistula; MRI |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I Medicine > Lehrstuhl für Innere Medizin II Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 20 Apr 2020 08:27 |
| Last Modified: | 20 Apr 2020 08:27 |
| URI: | https://pred.uni-regensburg.de/id/eprint/16940 |
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