Prevalence of fever in patients undergoing left atrial ablation of atrial fibrillation guided by barium esophagraphy.
BACKGROUND
Real-time esophageal imaging is critical in avoiding esophageal injury. However, the safety of esophageal imaging with barium has not been specifically explored.


METHODS
Three hundred seventy consecutive patients underwent left atrial (LA) ablation of atrial fibrillation (AF) under conscious sedation. One hundred eighty-five patients (50%) underwent the ablation procedure with, and 185 patients (50%) underwent the procedure without administration of barium. Fever, as a surrogate for aspiration, was defined as a maximal temperature >or=100 degrees F within the first 24 hours following the ablation procedure.


RESULTS
Thirty of the 370 patients (8%) developed fever within 24 hours after LA ablation. The prevalence of fever was 9% (17/185) among patients who received barium and 7% (13/185) among those who did not receive barium (P = 0.6). Evaluation revealed the following causes of fever in 14 of the 30 patients (47%) with no difference in prevalence between the 2 groups: pericarditis, venous thromboembolism, hematoma, and infiltrate on chest radiography. Multivariate analysis failed to reveal any factors associated with development of fever. None of the patients experienced serious complications such as respiratory failure or atrioesophageal fistula.


CONCLUSIONS
Fever may occur in approximately 10% of patients undergoing LA ablation of AF. Administration of barium is not associated with fever or other complications such as aspiration pneumonia. Real-time imaging of the esophagus with barium administration in conjunction with conscious sedation appears to be safe.
Ruby
Rubinder S
RS
Section of Electrophysiology/Division of Cardiology, University of Michigan Hospitals, Ann Arbor, Michigan, USA.
Wells
Darryl
D
Sankaran
Sundar
S
Good
Eric
E
Jongnarangsin
Krit
K
Ebinger
Matthew
M
Bogun
Frank
F
Pelosi
Frank
F
Oral
Hakan
H
Morady
Fred
F
Chugh
Aman
A
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D001465:Barium Radioisotopes; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods; D004945:Esophagoscopy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005334:Fever / Q000453:epidemiology* / Q000209:etiology; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011859:Radiography; D012189:Retrospective Studies
D001465:Barium Radioisotopes