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Esophageal injury associated with catheter ablation for atrial fibrillation: Determinants of risk and protective strategies.
Assis, Fabrizio R; Shah, Rushil; Narasimhan, Bharat; Ambadipudi, Sravya; Bhambhani, Hrithika; Catanzaro, John N; Calkins, Hugh; Tandri, Harikrishna.
Afiliación
  • Assis FR; Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Shah R; Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Narasimhan B; Department of Internal Medicine, Mount Sinai St. Lukes-Roosevelt, New York, New York.
  • Ambadipudi S; Department of Medicine, Division of Cardiology, Purdue University College of Pharmacy, West Lafayete, Indiana.
  • Bhambhani H; Department of Biological Sciences, University of Southern California, Los Angeles, California.
  • Catanzaro JN; Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida.
  • Calkins H; Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Tandri H; Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Cardiovasc Electrophysiol ; 31(6): 1364-1376, 2020 06.
Article en En | MEDLINE | ID: mdl-32323383
Catheter ablation has become an important element in the management of atrial fibrillation. Several technical advances allowed for better safety profiles and lower recurrence rates, leading to an increasing number of ablations worldwide. Despite that, major complications are still reported, and esophageal thermal injury remains a significant concern as atrioesophageal fistula (AEF) is often fatal. Recognition of the mechanisms involved in the process of esophageal lesion formation and the identification of the main determinants of risk have set the grounds for the development and improvement of different esophageal protective strategies. More sensitive esophageal temperature monitoring, safer ablation parameters and catheters, and different energy sources appear to collectively reduce the risk of esophageal thermal injury. Adjunctive measures such as the prophylactic use of proton-pump inhibitors, as well as esophageal cooling or deviation devices, have emerged as complementary methods with variable but promising results. Nevertheless, as a multifactorial problem, no single esophageal protective measure has proven to be sufficiently effective to eliminate the risk, and further investigation is still warranted. Early screening in the patients at risk and prompt intervention in the cases of AEF are important risk modifiers and yield better outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Quemaduras por Electricidad / Fístula Esofágica / Ablación por Catéter / Perforación del Esófago / Esófago / Lesiones Cardíacas Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Cardiovasc Electrophysiol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / FISIOLOGIA Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Quemaduras por Electricidad / Fístula Esofágica / Ablación por Catéter / Perforación del Esófago / Esófago / Lesiones Cardíacas Tipo de estudio: Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Cardiovasc Electrophysiol Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA / FISIOLOGIA Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos