Esophageal Capsule Endoscopy After Radiofrequency Catheter Ablation for Atrial Fibrillation Documented Higher Risk of Luminal Esophageal Damage With General Anesthesia as Compared With Conscious Sedation

被引：167

作者：

Di Biase, Luigi ^{[1
,2
,3
]}

Carlos Saenz, Luis ^{[5
]}

Burkhardt, David J. ^{[1
]}

Vacca, Miguel ^{[5
]}

Elayi, Claude S. ^{[3
]}

Barrett, Conor D. ^{[3
]}

Horton, Rodney ^{[1
]}

Bai, Rong ^{[3
]}

Siu, Alan ^{[3
]}

Fahmy, Tamer S. ^{[3
]}

Patel, Dimpi ^{[3
]}

Armaganijan, Luciana ^{[3
]}

Wu, Chia Tung ^{[3
]}

Kai, Sonne ^{[3
]}

Ching, Ching Keong ^{[3
]}

Phillips, Karen ^{[3
]}

Schweikert, Robert A. ^{[3
]}

Cummings, Jennifer E. ^{[3
]}

Arruda, Mauricio ^{[3
]}

Safiba, Wafid I. ^{[3
]}

Dodig, Milan ^{[3
]}

Natale, Andrea ^{[1
,4
]}

机构：

[1] St Davids Med Ctr, Texas Cardiac Arrhythmia Inst, Austin, TX 78705 USA

[2] Univ Foggia, Dept Cardiol, Foggia, Italy

[3] Cleveland Clin, Cleveland, OH 44106 USA

[4] Stanford Univ, Palo Alto, CA 94304 USA

[5] Fdn Cardio Infantil, Bogota, Colombia

来源：

CIRCULATION-ARRHYTHMIA AND ELECTROPHYSIOLOGY | 2009年 / 2卷 / 02期

关键词：

catheter ablation of atrial fibrillation; complications; esophageal injury; left atrioesophageal fistula; left atrium; VEIN ANTRUM ISOLATION; PULMONARY VEINS; TEMPERATURE; RELEVANCE; FISTULA; INJURY;

D O I：

10.1161/CIRCEP.108.815266

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background-Left atrioesophageal fistula is a rare but devastating complication that may occur after catheter ablation of atrial fibrillation. We used capsule endoscopy to assess esophageal injury after catheter ablation for atrial fibrillation in a population randomized to undergo general anesthesia or conscious sedation. Methods and Results-Fifty patients undergoing atrial fibrillation ablation for paroxysmal symptomatic atrial fibrillation refractory to antiarrhythmic drugs were enrolled and randomized, including those undergoing the procedure under general anesthesia (25 patients, group 1) and those receiving conscious sedation with fentanyl or midazolam (25 patients, group 2). All patients underwent esophageal temperature monitoring during the procedure. The day after ablation, all patients had capsule endoscopy to assess the presence of endoluminal tissue damage of the esophagus. We observed esophageal tissue damage in 12 (48%) patients of group 1 and 1 esophageal tissue damage in a single patient (4%) of group 2 (P<0.001). The maximal esophageal temperature was significantly higher in patients undergoing general anesthesia (group 1) versus patients undergoing conscious sedation (group 2) (40.6 +/- 1 degrees C versus 39.6 +/- 0.8 degrees C; P<0.003). The time to peak temperature was 9 7 seconds in group 1 and 21 9 seconds in group 2, and this difference was statistically significant (P<0.001). No complication occurred during or after the administration of the pill cam or during the procedures. All esophageal lesions normalized at the 2-month repeat endoscopic examination. Conclusion-The use of general anesthesia increases the risk of esophageal damage detected by capsule endoscopy. (Circ Arrhythmia Electrophysiol. 2009;2:108-112.)

引用

页码：108 / 112

页数：5

共 26 条

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