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Temporal Stability of the Location of the Esophagus in Patients Undergoing a Repeat Left Atrial Ablation Procedure for Atrial Fibrillation or Flutter
Author(s) -
KENNEDY ROBERT,
GOOD ERIC,
ORAL HAKAN,
HUETHER ELIZABETH,
BOGUN FRANK,
PELOSI FRANK,
MORADY FRED,
CHUGH AMAN
Publication year - 2008
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2007.01051.x
Subject(s) - esophagus , medicine , atrial fibrillation , ablation , atrial flutter , left pulmonary vein , radiofrequency ablation , catheter ablation , surgery , cardiology , pulmonary vein
Background:The esophagus may be mobile during a left atrial (LA) ablation procedure for atrial fibrillation (AF).Objective:The goal of the study was to determine whether the location of the esophagus is stable in patients undergoing a repeat LA ablation procedure.Methods:Forty‐two patients underwent repeat LA ablation a mean of 7 ± 2 months after the initial procedure. Cinefluoroscopic images of the esophagus during a barium swallow were recorded and the course of the esophagus was tagged on the 3D map. The position of the esophagus at the index and repeat procedure were compared.Results:At the index procedure, the esophagus was located near the left pulmonary veins (PVs) in 20 (48%), right PVs in 13 (31%), and at the mid LA in 9 (21%) patients. During the repeat procedure, the esophagus was found to be near the left PVs in 22 (52%), right PVs in 11 (26%), and at the mid LA in 9 patients (21%). In 35 of the 42 patients (83%), there was no change in the esophageal location, and in the remaining seven patients (17%), its position had shifted by ≥1 cm (range 1.0–4.0 cm).Conclusions:In more than 80% of patients presenting for a repeat LA ablation procedure, the esophagus is in the same position relative to the PVs as during the initial procedure. Therefore, if radiofrequency ablation at a particular location was limited by the position of the esophagus, safe ablation at that site is unlikely to be feasible during a repeat procedure.