New Study Published in HeartRhythm First To Link Anatomical and Procedural Data with Esophageal Lesions After Radiofrequency Ablation
FOR IMMEDIATE RELEASE
Contact: Kennesha Baldwin
Heart Rhythm Society
(202) 464-3476
kbaldwin@HRSonline.org
WASHINGTON, September 1, 2010 — New research released today is the first to find both anatomical and procedural considerations that can lead to the creation of esophageal ulcerations (ESUL) after radiofrequency ablation of atrial fibrillation (AF). According to a study published in the September issue of the HeartRhythm Journal, the official journal of the Heart Rhythm Society, patients at high-risk for esophageal injury can be identified based on pre-acquired multislice computed tomography. The study is the largest to provide serial endoscopy data on the esophagus after radiofrequency ablation.
The study population consisted of 275 patients admitted to the Elisabethinen University Teaching Hospital Linz for pulmonary vein (PV) isolation from September 2007 to June 2009. A standardized ablation approach using a 25-W energy maximum at the posterior left atrial (LA) wall without esophagus visualization, temperature monitoring or intracardiac ultrasound was performed. All patients were screened for evidence of the development of ESUL 24 hours after RFA. ESUL did not develop in any patient who had PV isolation alone.
Study analysis revealed that the greatest anatomical risk factor for the development of ESUL was a small LA-to-esophageal distance. Within the study population, the total risk of ulcers developing was 2.2 percent. Wall legions were classified as ESUL created by radiofrequency ablation by means of localization and endosonographic appearance. Anatomical factors included in the multivariate model were LA-to-esophageal distance, type of AF and additional LA linear lesions. LA-to-esophageal distance was the only independent predictor of the development of ESUL.
“It has been speculated that esophageal ulcerations can lead to atrioesophageal fistula, which is a rare but life-threatening complication of AF,” said lead author Martin Martinek, MD, Public Hospital Elisabethinen, Academic Teaching Hospital of the University of Innsbruck and Graz in Austria. “Our study aimed to discover risk factors that can lead to injuries of the esophagus due to radiofrequency ablation. In doing so, we may better identify high-risk patients to determine the most appropriate course of action for RFA and its follow-up.”
Access study:
The September edition of HeartRhythm has a special focus on Atrial Fibrillation. This study is one of the many included that covers procedures, treatments and outcomes specific to AF.
About HeartRhythm Journal
HeartRhythm provides rapid publication of the most important science developments in the field of arrhythmias and cardiovascular electrophysiology (EP). As the official journal of the Heart Rhythm Society, HeartRhythm publishes both basic and clinical subject matter of scientific excellence devoted to the EP of the heart and blood vessels, as well as therapy. The journal is the only EP publication serving the entire electrophysiology community from basic to clinical academic researchers, private practitioners, technicians, industry and trainees. HeartRhythm Journal has an impact factor of 4.559 (as of 2010) and ranks 11th out of 78 cardiovascular medicine journals worldwide by the Institute for Scientific Information, remaining the number one specialty journal in cardiology. It is also the official publication of the Cardiac Electrophysiology Society.
