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
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
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DOI：
10.1161/circep.108.815266
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发表时间：
2009-04-01
影响因子：
8.4
通讯作者：
Natale, Andrea
中科院分区：
文献类型：
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作者：
Di Biase, Luigi;Carlos Saenz, Luis;Natale, Andrea
背景-左房食管瘘是一种罕见但破坏性的并发症，可能发生在导管消融术后的房颤。方法和结果：50例因抗心律失常药物无效的阵发性房颤患者接受房颤消融术，其中全麻组25例，芬太尼或咪达唑仑镇静组25例。所有患者在手术过程中都接受了食道温度监测。消融后第二天，所有患者接受胶囊内窥镜检查，以评估是否存在食管腔内组织损伤。第1组12例(48%)，第2组1例(4%)。
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