Gastrointestinal complications associated with catheter ablation for atrial fibrillation.
Atrial fibrillation is the most common arrhythmia in the United States. With the ageing population, the incidence and prevalence of atrial fibrillation are on the rise. Catheter ablation of atrial fibrillation is a widely accepted treatment modality in patients with drug refractory symptomatic paroxysmal or persistent atrial fibrillation. The close proximity to the left atrium posterior wall makes the thermosensitive esophagus a potential site of injury during catheter ablation of AF leading to various gastrointestinal complications. The major gastrointestinal complications associated with catheter ablation include atrioesophageal fistula, gastroparesis, esophageal thermal lesions and esophageal ulcers. Multiple studies, case reports and series have described these complications with various catheter ablation techniques such as radiofrequency, cryoenergy and high frequency focused ultrasound energy ablation. This review addresses the gastrointestinal complications after AF ablation procedures and aims to provide the clinicians with an overview of clinical presentation, etiology, pathogenesis, prevention and management of these conditions.
Department of Medicine, Beaumont Health, Royal Oak, MI, United States.
Lohit
L
Garg
Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, United States. Electronic address: garg.jalaj@yahoo.com.
Jalaj
J
Garg
Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, United States.
Nancy
N
Gupta
Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, United States.
Neeraj
N
Shah
Department of Medicine, Division of Cardiology, Einstein Healthcare Network, Philadelphia, PA, United States.
Parasuram
P
Krishnamoorthy
Helmsley Electrophysiology Center, Mount Sinai School of Medicine, New York, NY, United States.
Chandrasekar
C
Palaniswamy
Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, United States.
Babak
B
Bozorgnia
Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, TX, United States.
Andrea
A
Natale
D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D004947:Esophagus / Q000293:injuries; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans
Ablation; Atrial fibrillation; Gastrointestinal complication