Garg Lohit, Garg Jalaj, Gupta Nancy, Shah Neeraj, Krishnamoorthy Parasuram, Palaniswamy Chandrasekar, Bozorgnia Babak, Natale Andrea
Department of Medicine, Beaumont Health, Royal Oak, MI, United States.
Division of Cardiology, Lehigh Valley Health Network, Allentown, PA, United States.
Int J Cardiol. 2016 Dec 1;224:424-430. doi: 10.1016/j.ijcard.2016.09.069. Epub 2016 Sep 24.
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.
心房颤动是美国最常见的心律失常。随着人口老龄化，心房颤动的发病率和患病率正在上升。对于药物难治性症状性阵发性或持续性心房颤动患者，导管消融是一种广泛接受的治疗方式。由于与左心房后壁距离很近，在房颤导管消融过程中，热敏性食管成为潜在的损伤部位，可导致各种胃肠道并发症。与导管消融相关的主要胃肠道并发症包括心房食管瘘、胃轻瘫、食管热损伤和食管溃疡。多项研究、病例报告及系列研究描述了这些并发症与各种导管消融技术，如射频、冷冻能量和高频聚焦超声能量消融的关系。本综述阐述了房颤消融术后的胃肠道并发症，旨在为临床医生提供这些病症的临床表现、病因、发病机制、预防及管理的概述。
