Open AccessPrevention of Esophageal Damage During Ablation of Atrial Fibrillation by the Esophagus Mechanical Deviation
Author(s) -
Enrique Indalécio Pachón Mateos,
José Carlos Pachón Mateos,
Ricardo Carneiro Amarante,
Carlos Thiene Cunha Pachón,
Tasso J. Lobo,
Tomás Guillermo Santillana Peña,
Juan Acosta,
Juán Carlos Pachón Mateos,
Felipe A. Ortencio,
Christian Higuti
Publication year - 2020
Publication title -
journal of cardiac arrhythmias
Language(s) - English
Resource type - Journals
eISSN - 2674-7472
pISSN - 2674-7081
DOI - 10.24207/jca.v32n4.982_in
Subject(s) - atrial fibrillation , esophagus , medicine , radiofrequency ablation , ablation , pulmonary vein , cardiology , pulmonary vein stenosis , stenosis , complication , population , surgery , environmental health
Atrial fibrillation is the most prevalent arrhythmia in the world population. Despite the use of antiarrhythmics, it is difficult to control clinically, causing symptoms and mainly generating risk of a thromboembolic event. Since 1998, by means of radiofrequency ablation, the treatment of atrial fibrillation has completely changed, but together with this important evolution complications from this ablative treatment technique have also started. In addition to the pulmonary vein stenosis caused by the ablation and later corrected with the change in the technique, atrioesophageal fistulas appeared due to the application of radiofrequency in the posterior wall of the left atrium. This wall is very close (0.5 cm onaverage) to the esophagus, which facilitates the formation of the fistula that leads to the death of almost 100% of the affected patients, despite the various treatment measurements already developed. To avoid this serious complication, several authors have created techniques to protect the esophagus including its mechanical deviation to a region opposite to the radiofrequency application, taking advantage of its mobility and easiness of handling. The mechanical deviation of the esophagus has proven to be the simplest, cheapest and most efficient way to protect this organ from radiofrequency thermal damage during atrial fibrillation ablation.