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Journal of Interventional Cardiac Electrophysiology

Erschienen in:

01.03.2014

The prevalence and risk factors for atrioesophageal fistula after percutaneous radiofrequency catheter ablation for atrial fibrillation: the Canadian experience

verfasst von: Krishna Kumar Mohanan Nair, Mohammed Shurrab, Allan Skanes, Asaf Danon, David Birnie, Carlos Morillo, Vijay Chauhan, Iqwal Mangat, Felix Ayala-Paredes, Jean Champagne, Isabelle Nault, Anthony Tang, Atul Verma, Ilan Lashevsky, Sheldon M. Singh, Eugene Crystal

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 2/2014

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Abstract

Purpose

Atrioesophageal fistula (AEF) is an infrequent complication of radiofrequency (RF) ablation for atrial fibrillation (AF). The aim of this study was to determine the prevalence and operator-dependent factors associated with AEF using a nationwide survey of electrophysiologists (EP).

Methods

Thirty-eight EPs performing AF ablation between 2008 and 2012 were invited to complete a web-based questionnaire assessing the prevalence and factors associated with AEF.

Results

Responses were obtained from 25 EPs (68 %) accounting for 7,016 AF ablations. Five cases of proven AEF (0.07 %) were reported. Operators who reported AEF [AEF (+)] more often used general anesthesia (GA) [90 % AEF (+) vs. 44 % AEF (−), p = 0.046]. AEF (+) operators were also more likely to be users of the non-brushing technique in the posterior wall of the LA [5 (100 %) AEF (+) vs. 5 (25 %) AEF (−), p = 0.005]. The combined usage of GA and non-brushing technique during LA posterior wall ablation had a strong association with AEF (+) operators [4 (80 %) AEF (+) vs. 2 (10 %) AEF (−), p = 0.002]. There was a trend towards higher maximal RF energy setting in the posterior wall [47.4 + 7.6 AEF (+) vs. 40.2 + 8 AEF (−), p = 0.09]. Other procedure parameters were similar.

Conclusions

The reported prevalence of AEF among Canadian AF ablators is 0.07 %. AEF was associated with high mortality. The use of GA and non-brushing movements during posterior wall ablation were two factors associated with AEF.

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Titel: The prevalence and risk factors for atrioesophageal fistula after percutaneous radiofrequency catheter ablation for atrial fibrillation: the Canadian experience
verfasst von: Krishna Kumar Mohanan Nair
Mohammed Shurrab
Allan Skanes
Asaf Danon
David Birnie
Carlos Morillo
Vijay Chauhan
Iqwal Mangat
Felix Ayala-Paredes
Jean Champagne
Isabelle Nault
Anthony Tang
Atul Verma
Ilan Lashevsky
Sheldon M. Singh
Eugene Crystal
Publikationsdatum: 01.03.2014
Verlag: Springer US
Erschienen in: Journal of Interventional Cardiac Electrophysiology / Ausgabe 2/2014
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI: https://doi.org/10.1007/s10840-013-9853-z

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The prevalence and risk factors for atrioesophageal fistula after percutaneous radiofrequency catheter ablation for atrial fibrillation: the Canadian experience