title: Long-term mobility of the esophagus in patients undergoing catheter ablation of atrial fibrillation: data from computer tomography and 3D rotational angiography of the left atrium.
abstract: OBJECTIVE
  Computed tomography (CT) and 3D rotational angiography (3DRA) of the left atrium (LA) are used to evaluate the esophagus prior to radiofrequency ablation for atrial fibrillation. The aim of this study was to compare preprocedural and periprocedural views of the esophagus and the left atrium.
  
  
  METHODS
  From September 2011 to August 2012, 3DRA and CT of the LA were performed on 56 patients before they underwent catheter ablation of atrial fibrillation. The 3DRA was performed periprocedurally, and the CT was performed an average of 20 days prior to the procedure. 3D models of the LA and the esophagus were then segmented on the EP Navigator V 3.1 workstation. Five positions of the esophagus, A-E, in order from left to right, were evaluated.
  
  
  RESULTS
  The most common position of the esophagus was behind the left part of the LA (CT, position B (n = 26)) and behind the central part of the LA (3DRA, position C (n = 21)). The maximum shift of the esophagus was three positions, and the average shift was 0.857 ± 0.766 of a position. There was a shift of one position in 44.6 % of the patients, two positions in 17.9 %, and three positions in 1.8 %. A statistically significant difference was found between the positions of the esophagus when the 3DRA and CT evaluations were compared.
  
  
  CONCLUSIONS
  The most common position of the esophagus was behind the middle and left part of the LA. The outpatient views of the esophagus obtained before ablation did not reflect the position of the esophagus at the beginning of the procedure.
authors.affiliation: International Clinical Research Center, 1st Department of Internal Medicine-Cardioangiology, St. Anne's University Hospital Brno, Pekařská 53, 656 91, Brno, Czech Republic. zdenek.starek@fnusa.cz.|Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic. zdenek.starek@fnusa.cz.
authors.forename: Zdeněk
authors.initials: Z
authors.lastname: Stárek
authors.affiliation: International Clinical Research Center, 1st Department of Internal Medicine-Cardioangiology, St. Anne's University Hospital Brno, Pekařská 53, 656 91, Brno, Czech Republic.|Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
authors.forename: František
authors.initials: F
authors.lastname: Lehar
authors.affiliation: International Clinical Research Center, 1st Department of Internal Medicine-Cardioangiology, St. Anne's University Hospital Brno, Pekařská 53, 656 91, Brno, Czech Republic.|Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
authors.forename: Jiří
authors.initials: J
authors.lastname: Jež
authors.affiliation: International Clinical Research Center, 1st Department of Internal Medicine-Cardioangiology, St. Anne's University Hospital Brno, Pekařská 53, 656 91, Brno, Czech Republic.|Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
authors.forename: Alena
authors.initials: A
authors.lastname: Žbánková
authors.affiliation: International Clinical Research Center, 1st Department of Internal Medicine-Cardioangiology, St. Anne's University Hospital Brno, Pekařská 53, 656 91, Brno, Czech Republic.|Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Kulík
authors.affiliation: International Clinical Research Center, 1st Department of Internal Medicine-Cardioangiology, St. Anne's University Hospital Brno, Pekařská 53, 656 91, Brno, Czech Republic.|Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
authors.forename: Jiří
authors.initials: J
authors.lastname: Wolf
authors.affiliation: International Clinical Research Center, 1st Department of Internal Medicine-Cardioangiology, St. Anne's University Hospital Brno, Pekařská 53, 656 91, Brno, Czech Republic.|Faculty of Medicine, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Novák
mesh_terms: D001281:Atrial Fibrillation / Q000000981:diagnostic imaging* / Q000601:surgery*; D017115:Catheter Ablation; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography; D004947:Esophagus / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009038:Motion; D011182:Postoperative Care; D011300:Preoperative Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012399:Rotation; D012680:Sensitivity and Specificity; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome
keywords: 3D rotational angiography of the left atrium; Atrial fibrillation; Atrioesophageal fistula; Catheter ablation of arrhythmias; Computer tomography of the heart; Esophagus imaging