Usefulness of Esophageal Leads for Determining the Strategy of Pulmonary Vein Ablation to Avoid Complications Associated With the Esophagus

Takumi Yamada, Yoshimasa Murakami, Taro Okada, Mitsuhiro Okamoto, Takeshi Shimizu, Junji Toyama, Yukihiko Yoshida, Naoya Tsuboi, Teruo Ito, Masahiro Muto, Takahisa Kondo, Yasuya Inden, Makoto Hirai, Toyoaki Murohara

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

To avoid fatal complications after extensive pulmonary vein (PV) ablation, it has been proved important to comprehend the anatomic relation between the PVs and the esophagus. In 42 consecutive patients with atrial fibrillation, PV ostial isolation was performed using a basket catheter. The shortest distance and anatomic relation between the esophageal lead and PV ostium, determined by successful PV ostial isolation, was analyzed in biplane fluoroscopic views. In 18 left superior PVs (LSPVs) (43%), 13 left inferior PVs (32%) (LIPVs), and all the right PVs (group A), the shortest distance was >10 mm in ≥1 of the biplane fluoroscopic views. In 4 LSPVs (10%) and 2 LIPVs (5%) (group B), the shortest distance was ≤5 mm in the fluoroscopic views. In the remaining PVs (group C), the esophagus was situated directly behind 10 LSPVs (24%) and 12 LIPVs (29%) (group C1), posteromedial to 1 LSPV (2%) and 9 LIPVs (22%) (group C2), and medial to 9 LSPVs (21%) and 5 LIPVs (12%) (group C3). The risk of esophagus-associated complications with ablation around the left PV ostia was suggested to be high in group B, very low in group A, and relatively low in group C. In group C3, extensive PV ablation might increase the risk of that complication. In conclusion, esophageal leads are useful for determining strategies for PV ablation to avoid esophagus-associated complications, because they enable comprehension of the anatomic relation between the PVs and the esophagus.

Original languageEnglish (US)
Pages (from-to)1494-1497
Number of pages4
JournalAmerican Journal of Cardiology
Volume97
Issue number10
DOIs
StatePublished - May 15 2006
Externally publishedYes

Bibliographical note

Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.

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