Abstract:
BACKGROUND:Left atrial catheter ablation (LACA) has emerged as a successful method to eliminate atrial fibrillation (AF). Recent reports have described atrio-esophageal fistulas, often resulting in death, from this procedure. Temporary esophageal stenting is an established therapy for malignant esophageal disease. We describe the first case of successful temporary esophageal stenting for an esophageal perforation following LACA. CASE:A 48-year-old man with symptomatic drug refractory lone AF underwent an uneventful LACA. Fifty-nine ablations with an 8-mm tip ablation catheter (30 seconds, 70 Watts, 55 degrees C), as guided by 3-D NavX mapping, were performed in the left atrium to isolate the pulmonary veins as well as a left atrial flutter and roof ablation line. In addition, complex atrial electrograms in AF and sites of vagal innervation were ablated. Two weeks later, he presented with sub-sternal chest pain, fever, and dysphagia. A chest CT showed a 3-mm esophageal perforation at the level of the left atrium with mediastinal soiling and no pericardial effusion. An urgent upper endoscopy with placement of a PolyFlex removable esophageal stent to seal off the esophago-mediastinal fistula was performed. After 3 weeks of i.v. antibiotics, naso-jejunal tube feedings, and esophageal stenting, the perforation resolved and the stent was removed. Over 18 months of follow-up, there have been no other complications, and he has returned to a physically active life and remains free from AF on previously ineffective anti-arrhythmic drugs. CONCLUSION:Early diagnosis of esophageal perforations following LACA may allow temporary esophageal stenting with successful esophageal healing. Prompt chest CT scans with oral and i.v. contrast should be considered in any patient with sub-sternal chest pain or dysphagia following LACA.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Bunch TJ,Nelson J,Foley T,Allison S,Crandall BG,Osborn JS,Weiss JP,Anderson JL,Nielsen P,Anderson L,Lappe DL,Day JDdoi
10.1111/j.1540-8167.2006.00464.xsubject
Has Abstractpub_date
2006-04-01 00:00:00pages
435-9issue
4eissn
1045-3873issn
1540-8167pii
JCE464journal_volume
17pub_type
杂志文章abstract:BACKGROUND:Myocardial depolarization can be altered by varying pacing stimulus output. This may have implications on response rates for cardiac resynchronization therapy (CRT). The purpose of our study was to determine the relationship of left ventricular (LV) pacing stimulus intensity to measures of depolarization and...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2008.01378.x
更新日期:2009-06-01 00:00:00
abstract:INTRODUCTION:We compared the efficacy and safety of amiodarone and dronedarone in patients with persistent atrial fibrillation (AF). METHODS:Five hundred and four amiodarone-naïve patients were randomized to receive dronedarone 400 mg bid (n = 249) or amiodarone 600 mg qd for 28 days then 200 mg qd (n = 255) for at le...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1540-8167.2010.01764.x
更新日期:2010-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/jce.12951
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Perforation during catheter procedures in either the atrium or ventricle is relatively uncommon, but potentially fatal if tamponade ensues. This study analyzes the occurrence and outcomes of cardiac perforation during catheter-based radiofrequency ablation procedures in the left atrium. METHODS:All patients...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2005.50135.x
更新日期:2005-11-01 00:00:00
abstract:INTRODUCTION:Following myocardial infarction (MI), left ventricular function is determined by cardiac remodeling occurring in both infarcted and noninfarcted myocardium (NIM). Unipolar voltage mapping may detect remodeling changes in NIM that are associated with the left ventricular ejection fraction (LVEF). We aimed t...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12315
更新日期:2014-03-01 00:00:00
abstract::Left-sided anteroseptal accessory pathways that course through the aortomitral fibrous continuity are some of the rarest types of accessory pathways. At this region the atrium and ventricle are separated by their greatest distance because of the intervening aortic valve. These pathways often have a long circuitous cou...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2012.02440.x
更新日期:2013-04-01 00:00:00
abstract:INTRODUCTION:The utility of "virtual" imaging systems for left atrial (LA) navigation has been hampered by inadequate spatial detail, as well as inaccurate integration of more detailed preoperative images, such as those generated by computed tomography (CT). CartoSound is an intracardiac echocardiography (ICE)-based te...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01672.x
更新日期:2010-06-01 00:00:00
abstract::We report the case of a 71-year-old man with two atrial tachycardias evolving simultaneously and independently in two dissociated regions after extensive ablation for chronic atrial fibrillation. One tachycardia was a focal tachycardia originating from the right inferior pulmonary vein and activating the posterior lef...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2007.01067.x
更新日期:2008-09-01 00:00:00
abstract:INTRODUCTION:Catheter stimulation of the inferior interatrial ganglionated parasympathetic plexus decreases the ventricular rate during atrial fibrillation (AF) in humans. However, the relatively high stimulation voltages might prevent implementation of neurostimulation in chronic implantable devices. From myocardial e...
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pub_type: 杂志文章
doi:10.1111/j.1540-8167.2005.00248.x
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abstract:INTRODUCTION:Significant species-, tissue-, and age-dependent differences have been described for the L-type calcium current (ICa). Therefore, extrapolation of data obtained from the many animal models to human cardiac physiology is difficult. In this study, we have characterized the voltage-dependent properties of ICa...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1993.tb01281.x
更新日期:1993-08-01 00:00:00
abstract:INTRODUCTION:Idiopathic ventricular tachycardia (VT) originating in or close to the anterior fascicle of the left bundle is rare. A patient with no structural heart disease and VT with a right bundle branch block configuration and right-axis deviation underwent an electrophysiologic examination. METHODS AND RESULTS:Bo...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1996.tb00500.x
更新日期:1996-12-01 00:00:00
abstract::The incidence of atrial fibrillation (AF) in Brugada syndrome (BrS) has been reported at between 9% and 53% by different series, but the true prevalence is unknown. However, AF may be the presenting feature in some patients. The underlying mechanisms for AF may be a combination of multiple factors, genetic or acquired...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:10.1111/jce.14361
更新日期:2020-04-01 00:00:00
abstract:INTRODUCTION:Atrial arrhythmias have emerged as a topic of great interest for clinical electrophysiologists. Noninvasive imaging of electrical function in humans may be useful for computer-aided diagnosis and treatment of cardiac arrhythmias, which can be accomplished by the fusion of data from ECG mapping and magnetic...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.2003.02558.x
更新日期:2003-07-01 00:00:00
abstract:INTRODUCTION:We performed a systematic review and meta-analysis of geographic and racial representation and reported success rates of studies of catheter ablation for atrial fibrillation (AF). METHODS AND RESULTS:We searched PubMed, Scopus, and Cochrane databases from 1/1/1990 to 8/1/2016 for trials and observational ...
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pub_type: 杂志文章,meta分析
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更新日期:2018-05-01 00:00:00
abstract:INTRODUCTION:Transvenous cryoablation has proven to be safe and effective for the treatment of supraventricular arrhythmias. The aim of this prospective study was to report the feasibility and safety of catheter-based cryoablation for the treatment of postinfarction and idiopathic ventricular tachycardia (VT). METHODS...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2009.01610.x
更新日期:2010-03-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,评审
doi:
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Individual risk factors of intraprocedural cardiac injury (cardiac perforation and tamponade) during implantable cardioverter defibrillator (ICD) placement have been documented. However, the prognostic impact of their coexistence has not been explored. OBJECTIVE:To develop a risk score model to identify pat...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.13823
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:Conventional electrical therapies for heart failure (HF) encompass defibrillation and ventricular resynchronization for patients at high risk for lethal arrhythmias and/or with inhomogeneous ventricular contraction. Cardiac contractility modulation (CCM) by means of nonexcitatory electrical currents delive...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1046/j.1540-8167.2004.03580.x
更新日期:2004-04-01 00:00:00
abstract:INTRODUCTION:Electrophysiological mapping (EPM) in coronary sinus (CS) branches is feasible for guiding LV lead placement to the optimal, latest activated site at cardiac resynchronization therapy (CRT) procedures. However, whether this procedure optimizes the response to CRT has not been demonstrated. This study was t...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12771
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Hemodynamic instability hinders activation and entrainment mapping during ventricular tachycardia ablation. The Impella 2.5 microaxial flow device (MFD; Abiomed Inc., Danvers, MA, USA) is used to prevent hemodynamic instability during electrophysiologic study. However, electromagnetic interference (EMI) gene...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12437
更新日期:2014-07-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
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更新日期:2020-11-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01437.x
更新日期:2009-07-01 00:00:00
abstract:AIMS:T-wave alternans (TWA) is an indicator of vulnerability to ventricular arrhythmias and is useful for predicting sudden cardiac death (SCD) in patients with various structural heart diseases. We evaluated whether high levels of time-domain TWA on ambulatory ECG (AECG) are associated with a history of ventricular fi...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.12441
更新日期:2014-09-01 00:00:00
abstract:INTRODUCTION:Results of previous studies suggest that atrial resynchronization by multisite atrial pacing may contribute to prevention of recurrences in patients with drug-refractory atrial tachyarrhythmias and significant intra-atrial conduction delay. METHODS AND RESULTS:To verify this hypothesis, a prospective nonc...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2000.tb01752.x
更新日期:2000-10-01 00:00:00
abstract::Pulmonary vein (PV) arrhythmogenicity underlying the maintenance of atrial fibrillation (AF) may be explained by three mechanisms: enhanced automaticity, triggered activity, and reentry. There are only a few reports describing sustained PV tachycardias (PVT) following electrical disconnection from the left atrium, in ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2006.00713.x
更新日期:2007-04-01 00:00:00
abstract:INTRODUCTION:The effects of adenosine on atrial tachycardia (AT) remain controversial, and the mechanistic implications of adenosine termination have not been fully established. The purpose of this study was to elucidate the differential effects of adenosine on focal and macroreentrant AT and describe the characteristi...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.1999.tb00705.x
更新日期:1999-04-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2008.01364.x
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Catheter ablation is an effective treatment for symptomatic individuals with atrial fibrillation (AF) but is associated with a risk of periprocedual stroke. Recent data suggest that this risk may be abolished if catheter ablation is performed with uninterrupted warfarin (UW). We sought to compare the inciden...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究
doi:10.1111/jce.12411
更新日期:2014-06-01 00:00:00
abstract:INTRODUCTION:The relationship between the determining factors and beating rates of pulmonary vein (PV) pacemaker cardiomyocytes has not been fully elucidated. The purposes of this study were to compare the electrophysiological characteristics between PV fast and slow pacemaker cardiomyocytes. METHODS:Whole-cell patch ...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2009.01480.x
更新日期:2009-09-01 00:00:00
abstract::Atrial arrhythmias are quite common in patients after heart transplantation; they can occur via focal or reentrant mechanisms and are amenable to curative therapy with catheter ablation. Integration of the individual patient's surgical anatomy with the arrhythmia pattern on 12-lead electrocardiogram can help both to n...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2011.02106.x
更新日期:2012-02-01 00:00:00