title: Incidental and ablation-induced findings during upper gastrointestinal endoscopy in patients after ablation of atrial fibrillation: a retrospective study of 425 patients.
abstract: BACKGROUND
  Although rare, atrioesophageal fistula is a serious and often lethal complication of radiofrequency catheter ablation in patients with atrial fibrillation (AF). Consequently, esophagogastroduodenoscopy after AF catheter ablation has been suggested to detect thermal esophageal lesions.
  
  
  OBJECTIVE
  To report the incidence of thermal lesions and other incidental gastrointestinal (GI) abnormalities in patients with AF after radiofrequency catheter ablation.
  
  
  METHODS
  Four hundred twenty-five (mean age 59 ± 10 years; 64% men) consecutive patients with symptomatic AF who underwent left atrial radiofrequency catheter ablation were scheduled for upper GI endoscopy 1-3 days after the procedure. Patients were asymptomatic for GI diseases, that is, exhibiting no dysphagia, heart burn, or abdominal pain.
  
  
  RESULTS
  Pathological GI findings were observed in 328 (77%) patients and included gastral erosions (22%), esophageal erythema (21%), gastroparesis (17%), hiatal hernia (16%), reflux esophagitis (12%), thermal esophageal lesion (11%), and suspected Barrett's esophagus (5%). Biopsies were performed in 70 (17%) patients, showing gastritis (84%), Helicobacter pylori colonization (17%) and mucosa-associated lymphoid tissue (17%), esophagitis (9%), and Barrett's esophagus (4%). Further diagnostic workup or treatment was initiated in 105 (25%) patients.
  
  
  CONCLUSIONS
  Upper GI pathologies are observed frequently in asymptomatic patients. Half of all patients have a requirement for treatment. Among the findings, thermal esophageal lesions and gastroparesis can be attributed to AF catheter ablation. The high incidence of gastroparesis is a novel finding that deserves further investigation.
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Knopp
authors.affiliation: Department of Internal Medicine II, Park Hospital, Leipzig, Germany.
authors.forename: U
authors.initials: U
authors.lastname: Halm
authors.affiliation: Department of Internal Medicine II, Park Hospital, Leipzig, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Lamberts
authors.affiliation: Department of Internal Medicine II, Park Hospital, Leipzig, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Knigge
authors.affiliation: Department of Internal Medicine II, Park Hospital, Leipzig, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Zachäus
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Sommer
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Richter
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Bollmann
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Hindricks
authors.affiliation: Department of Electrophysiology, Heart Center, Leipzig, Germany. Electronic address: dani11@gmx.net.
authors.forename: D
authors.initials: D
authors.lastname: Husser
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects*; D016145:Endoscopy, Digestive System; D016099:Endoscopy, Gastrointestinal; D004937:Esophageal Fistula / Q000209:etiology*; D005260:Female; D005402:Fistula / Q000209:etiology; D018589:Gastroparesis / Q000209:etiology / Q000473:pathology; D006325:Heart Atria; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Atrial fibrillation; Gastric hypomotility; Gastroparesis; Incidental findings; Radiofrequency ablation