Advertisement

CA-528-02 SHORT-TERM NATURAL COURSE OF ESOPHAGEAL THERMAL INJURY AFTER RADIOFREQUENCY CATHETER ABLATION FOR ATRIAL FIBRILLATION

      Background

      Although esophagogastroduodenoscopy (EGD) is a good modality for assessing post ablation esophageal thermal injury (ETI), few details are known about the short-term healing or progression of esophageal injury.

      Objective

      Provide further insight into the short-term natural history of ETI and clinical outcome based upon repeated EGD imaging with use guided by late-gadolinium enhancement magnetic resonance imaging (LGE MRI).

      Methods

      A retrospective analysis of 378 patients who underwent EGD based on the findings on the esophagus by post-ablation LGE MRI imaging after left atrium radiofrequency ablation for atrial fibrillation from 2010-2019 at our institution. We defined ETI according to the Kansas City classification (type 1: erythema, 2a: superficial ulcers, 2b: deep ulcers, 3a: perforation without communication with the atria, 3b: perforation with atrioesophageal fistula, AEF). Repeated EGD was performed within 1-14 days after the first EGD until healing signs were observed.

      Results

      Esophageal lesions were detected by initial EGD in 62 patients (mean age; 64.2 ± 13.0, female; 43.5%, 21%; type 1, 50%; type 2a, 29%; type 2b) and 43 patients underwent repeated EGDs. In these 43 patients, all lesions showed healing signs in repeated EGD within 14 days after ablation but one type 2b lesion which showed enlarging injury in repeated EGD and finally developed into an AEF.