Journal ArticleDOI
Clinical characteristics and management of periesophageal vagal nerve injury complicating left atrial ablation of atrial fibrillation: lessons from eleven cases.
Taishi Kuwahara,Atsushi Takahashi,Yoshihide Takahashi,Atushi Kobori,Shinsuke Miyazaki,Asumi Takei,Tadashi Fujino,Kenji Okubo,Katsumasa Takagi,Akira Fujii,Masateru Takigawa,Yuji Watari,Hiroyuki Hikita,Akira Sato,Kazutaka Aonuma +14 more
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TLDR
This study aimed to elucidate the clinical characteristics and management of periesophageal vagal nerve injury complicating the ablation of atrial fibrillation (AF).Abstract:
Postablation Gastroparesis Features and TreatmentIntroduction
This study aimed to elucidate the clinical characteristics and management of periesophageal vagal nerve injury complicating the ablation of atrial fibrillation (AF).
Methods and Results
A total of 3,695 patients with drug-resistant AF underwent extensive pulmonary vein isolation at our institution. Either a nonirrigated or an irrigated ablation catheter was employed, with radiofrequency power of 25–40 W. Esophageal temperature was monitored in 3,538 patients: when the esophageal temperature reached 42°C radiofrequency delivery was stopped. A total of 11 patients (60 ± 11 years, 10 males) were diagnosed as having a periesophageal vagal nerve injury after the AF ablation. Symptoms included nausea, vomiting, bloating, constipation, and gastric pain, which occurred within 72 hours after the procedure. Gastrointestinal fluoroscopy and/or endoscopy revealed gastric hypomotility (10 patients) and pyloric spasm (1 patient). Intravenous erythromycin (3 mg/kg every 8 hours) was effective in relieving symptoms in 5 patients, and the patient with pyloric spasm underwent esophagojejunal anstomosis. Eight patients almost fully recovered within 40 days; however, 3 patients suffered from severe symptoms for 3–12 months. This complication occurred in 4 of the 157 patients (2.5%) who did not have esophageal temperature monitoring, and 7 of the 3,538 (0.2%) who did (P = 0.0007). The 3 patients with persistent severe symptoms received no esophageal temperature monitoring.
Conclusion
The clinical course and severity of the periesophageal vagal nerve injury varied, but most patients finally recovered with conservative treatment. Radiofrequency delivery under esophageal temperature monitoring might reduce both the incidence and the severity of this complication.read more
Citations
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Journal ArticleDOI
2017 HRS / EHRA / ECAS / APHRS / SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation
Hugh Calkins,Gerhard Hindricks,Riccardo Cappato,Young Hoon Kim,Eduardo B. Saad,Luis Aguinaga,Joseph G. Akar,Vinay Badhwar,Josep Brugada,John Camm,Peng Sheng Chen,Shih Ann Chen,Mina K. Chung,Jens Cosedis Nielsen,Anne B. Curtis,D. Wyn Davies,John D. Day,Andre d'Avila,N. M. S. de Groot,Luigi Di Biase,Mattias Duytschaever,James R. Edgerton,Kenneth A. Ellenbogen,Patrick T. Ellinor,Sabine Ernst,Guilherme Fenelon,Edward P. Gerstenfeld,David E. Haines,Michel Haïssaguerre,Robert H. Helm,Elaine M. Hylek,Warren M. Jackman,José Jalife,José Jalife,Jonathan M. Kalman,Josef Kautzner,Hans Kottkamp,Karl Heinz Kuck,Koichiro Kumagai,Richard Lee,Thorsten Lewalter,Bruce D. Lindsay,Laurent Macle,Moussa Mansour,Francis E. Marchlinski,Gregory F. Michaud,Hiroshi Nakagawa,Andrea Natale,Stanley Nattel,Ken Okumura,Douglas L. Packer,Evgeny Pokushalov,Matthew R. Reynolds,Prashanthan Sanders,Mauricio Scanavacca,Richard J. Schilling,Claudio Tondo,Hsuan Ming Tsao,Atul Verma,David J. Wilber,Teiichi Yamane +60 more
TL;DR: This 2017 Consensus Statement is to provide a state-of-the-art review of the field of catheter and surgical ablation of AF and to report the findings of a writing group, convened by these five international societies.
Journal ArticleDOI
2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary
Hugh Calkins,Gerhard Hindricks,Riccardo Cappato,Young Hoon Kim,Eduardo B. Saad,Luis Aguinaga,Joseph G. Akar,Vinay Badhwar,Josep Brugada,John Camm,Peng Sheng Chen,Shih Ann Chen,Mina K. Chung,Jens Cosedis Nielsen,Anne B. Curtis,D. Wyn Davies,John D. Day,Andre d'Avila,N. M. S. de Groot,Luigi Di Biase,Mattias Duytschaever,James R. Edgerton,Kenneth A. Ellenbogen,Patrick T. Ellinor,Sabine Ernst,Guilherme Fenelon,Edward P. Gerstenfeld,David E. Haines,Michel Haïssaguerre,Robert H. Helm,Elaine M. Hylek,Warren M. Jackman,José Jalife,José Jalife,Jonathan M. Kalman,Josef Kautzner,Hans Kottkamp,Karl Heinz Kuck,Koichiro Kumagai,Richard Lee,Thorsten Lewalter,Bruce D. Lindsay,Laurent Macle,Moussa Mansour,Francis E. Marchlinski,Gregory F. Michaud,Hiroshi Nakagawa,Andrea Natale,Stanley Nattel,Ken Okumura,Douglas L. Packer,Evgeny Pokushalov,Matthew R. Reynolds,Prashanthan Sanders,Mauricio Scanavacca,Richard J. Schilling,Claudio Tondo,Hsuan Ming Tsao,Atul Verma,David J. Wilber,Teiichi Yamane +60 more
TL;DR: This 2017 Consensus Statement is to provide a state-of-the-art review of the field of catheter and surgical ablation of AF and to report the findings of a writing group, convened by these five international societies.
Journal ArticleDOI
2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary
Hugh Calkins,Gerhard Hindricks,Riccardo Cappato,Young Hoon Kim,Eduardo B. Saad,Luis Aguinaga,Joseph G. Akar,Vinay Badhwar,Josep Brugada,John Camm,Peng Sheng Chen,Shih Ann Chen,Mina K. Chung,Jens Cosedis Nielsen,Anne B. Curtis,D. Wyn Davies,John D. Day,Andre d'Avila,N. M. S. de Groot,Luigi Di Biase,Mattias Duytschaever,James R. Edgerton,Kenneth A. Ellenbogen,Patrick T. Ellinor,Sabine Ernst,Guilherme Fenelon,Edward P. Gerstenfeld,David E. Haines,Michel Haïssaguerre,Robert H. Helm,Elaine M. Hylek,Warren M. Jackman,José Jalife,José Jalife,Jonathan M. Kalman,Josef Kautzner,Hans Kottkamp,Karl Heinz Kuck,Koichiro Kumagai,Richard Lee,Thorsten Lewalter,Bruce D. Lindsay,Laurent Macle,Moussa Mansour,Francis E. Marchlinski,Gregory F. Michaud,Hiroshi Nakagawa,Andrea Natale,Stanley Nattel,Stanley Nattel,Stanley Nattel,Ken Okumura,Douglas L. Packer,Evgeny Pokushalov,Matthew R. Reynolds,Prashanthan Sanders,Prashanthan Sanders,Mauricio Scanavacca,Richard J. Schilling,Claudio Tondo,Hsuan Ming Tsao,Atul Verma,David J. Wilber,Teiichi Yamane +63 more
TL;DR: The 2017 Consensus Statement on Catheter and Surgical Atrial Fibrillation (CA-ABlation) as mentioned in this paper provides a state-of-the-art review of the field of catheter and surgical ablation of atrial fibrillation and to report the findings of a writing group, convened by these five international societies.
Journal ArticleDOI
2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation
Hugh Calkins,Gerhard Hindricks,Riccardo Cappato,Young Hoon Kim,Eduardo B. Saad,Luis Aguinaga,Joseph G. Akar,Vinay Badhwar,Josep Brugada,John Camm,Peng Sheng Chen,Shih Ann Chen,Mina K. Chung,Jens Cosedis Nielsen,Anne B. Curtis,D. Wyn Davies,John D. Day,Andre d'Avila,N. M. S. de Groot,Luigi Di Biase,Mattias Duytschaever,James R. Edgerton,Kenneth A. Ellenbogen,Patrick T. Ellinor,Sabine Ernst,Guilherme Fenelon,Edward P. Gerstenfeld,David E. Haines,Michel Haïssaguerre,Robert H. Helm,Elaine M. Hylek,Warren M. Jackman,José Jalife,Jonathan M. Kalman,Josef Kautzner,Hans Kottkamp,Karl Heinz Kuck,Koichiro Kumagai,Richard Lee,Thorsten Lewalter,Bruce D. Lindsay,Laurent Macle,Moussa Mansour,Francis E. Marchlinski,Gregory F. Michaud,Hiroshi Nakagawa,Andrea Natale,Stanley Nattel,Ken Okumura,Douglas L. Packer,Evgeny Pokushalov,Matthew R. Reynolds,Prashanthan Sanders,Mauricio Scanavacca,Richard J. Schilling,Claudio Tondo,Hsuan Ming Tsao,Atul Verma,David J. Wilber,Teiichi Yamane +59 more
TL;DR: The next generation of teachers and researchers will shape the future of teaching and learning in the developing world through a generation of interpreters and interpreters.
Journal ArticleDOI
Effect of Atrial Fibrillation Ablation on Gastric Motility The Atrial Fibrillation Gut Study
Dhanunjaya Lakkireddy,Yeruva Madhu Reddy,Donita Atkins,Johnson Rajasingh,Arun Kanmanthareddy,Mojtaba Olyaee,Reginald Dusing,Rhea Pimentel,Sudharani Bommana,Buddhadeb Dawn +9 more
TL;DR: Atrial fibrillation ablation results in functional impairment of the UGI system, including the esophagus, stomach, and small intestine, which is probably mediated by the injury to the components of the vagal nerve.
References
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Journal ArticleDOI
Improvement of gastric emptying in diabetic gastroparesis by erythromycin : preliminary studies
Jozef Janssens,T L Peeters,Gaston Vantrappen,Jan Tack,J L Urbain,M. De Roo,Erik Muls,Roger Bouillon +7 more
TL;DR: Preliminary results suggest that erythromycin may have therapeutic value in patients with severe diabetic gastroparesis, and shortened the prolonged gastric-emptying times for both liquids and solids to normal.
Journal ArticleDOI
Botulinum toxin A for the treatment of delayed gastric emptying.
TL;DR: Intrapyloric injection of botulinum toxin improves gastric emptying in patients with gastroparesis, although this benefit was not superior to placebo at 1 month, and symptoms do not improve significantly by 1 month after injection.
Journal ArticleDOI
Clinical trial: a randomized-controlled crossover study of intrapyloric injection of botulinum toxin in gastroparesis.
Joris Arts,Lieselot Holvoet,P Caenepeel,Raf Bisschops,Daniel Sifrim,Kristin Verbeke,Jozef Janssens,Jan Tack +7 more
TL;DR: Uncontrolled studies suggest benefit of intrapyloric injection of botulinum toxin (botox) for the treatment of gastroparesis, but controlled data are lacking.
Journal ArticleDOI
Treatment of idiopathic gastroparesis with injection of botulinum toxin into the pyloric sphincter muscle
Larry S. Miller,Gregory A. Szych,Steven Kantor,Matthew Q. Bromer,Linda C. Knight,Alan H. Maurer,Robert S. Fisher,Henry P. Parkman +7 more
TL;DR: Treatment of idiopathic gastroparesis with injection of botulinum toxin into the pyloric sphincter muscle is described in this article, where the injection is performed by injection of a botulinus toxin.
Journal ArticleDOI
Acute Pyloric Spasm and Gastric Hypomotility: An Extracardiac Adverse Effect of Percutaneous Radiofrequency Ablation for Atrial Fibrillation
Dipen Shah,Jean-Marc Dumonceau,Haran Burri,Henri Sunthorn,Andreas Schroft,Pascale Gentil-Baron,Yasuhiro Yokoyama,Atsushi Takahashi +7 more
TL;DR: Marked anatomic variability of periesophageal vagi renders it difficult to reliably avoid the area overlying this plexus, therefore, it is advocated a reduction in maximum RF power and application duration on all of the posterior LA to try to avoid this complication.
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