Esophageal positions relative to the left atrium; data from 293 patients before catheter ablation of atrial fibrillation
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Date
2018-01
Journal Title
Journal ISSN
Volume Title
Publisher
Cardiological Society of India
Abstract
Aims
Three-dimensional rotational angiography (3DRA) of the left atrium (LA) and the esophagus is a simple and safe method for analyzing the relationship between the esophagus and the LA during catheter ablation of atrial fibrillation. The purpose of this study is to describe the location of the esophagus relative to the LA and mobility of the esophagus during ablation procedure.
Methods
From 3/2011 to 9/2015, 3DRA of the LA and esophagus was performed in 326 patients before catheter ablation of atrial fibrillation. 3DRAwas performed with visualization of the esophagus via peroral administration of a contrast agent. The positions of the esophagus were determined at the beginning of the procedure, for part of patients also at the end of procedure with contrast esophagography.
Results
The most frequent position is behind the center of the LA (91 pts., 31.9%) The least frequent position is behind the right pulmonary veins (27 pts., 9.4%). The average shift of the esophagus position was 3.36 ± 2.15 mm, 3.59 ± 2.37 mm and 3.67 ± 3.23 mm for superior, middle and inferior segment resp.
Conclusions
The position of the esophagus to the LA is highly variable. The most common position of the esophagus relative to the LA is behind the middle and left part of the posterior wall of the LA. The least frequently observed position is behind the right pulmonary veins. No significant position change of esophagus motion from before to after the ablation procedure in the majority (≥95%) of the patients was observed.
Description
Keywords
3D rotational angiography of the left atrium and esophagus, Position of esophagus to the left atrium, Image integration, Catheter ablation of atrial fibrillation, Atrioesophageal fistula, Shortterm mobility of the esophagus
Citation
Starek Zdenek, Lehar Frantisek, Jez Jiri, Scurek Martin, Wolf Jiri, Kulik Tomas, Zbankova Alena. Esophageal positions relative to the left atrium; data from 293 patients before catheter ablation of atrial fibrillation. Indian Heart Journal. 2018 Jan; 70(1): 37-44