Publish in this journal
Journal Information
NOTICE Undefined index: paginaFinal (librerias/utilidadesHtml-cardio.php[88])
Vol. 61. Issue 11.
Pages 1204- (November 2008)
Share
Share
Download PDF
More article options
NOTICE Undefined index: paginaFinal (librerias/utilidadesHtml-cardio.php[88])
Vol. 61. Issue 11.
Pages 1204- (November 2008)
DOI: 10.1016/S1885-5857(09)60034-7
Full text access
Visualization of the Esophagus During Pulmonary Vein Isolation
Visualización del esófago durante aislamiento de venas pulmonares
Visits
5523
Jorge Toqueroa, Ignacio Fernández-Lozanoa, Juan M Escudiera
a Unidad de Arritmias, Servicio de Cardiología, Hospital Puerta de Hierro, Madrid, Spain
This item has received
5523
Visits
Article information
Full Text
Download PDF
Statistics
Figures (1)
Full Text

Figure.

Atrioesophageal fistula is one of the most serious complications of pulmonary vein (PV) isolation. We describe a technique to monitor esophageal position during this procedure.

A 39-year-old patient with atrial fibrillation underwent pulmonary vein isolation under guidance of the EnSite NavXTM electroanatomic navigation system. To avert unintentional esophageal injury, a tetrapolar electrode for transesophageal stimulation was inserted by nasogastric access, advanced to a retroatrial position, and connected to the NavXTM system. The image shows a cranial view (A) and a posterior view (B), with the tetrapolar electrode (dark blue) within the esophagus between the 2 ablation lines around the right and left pulmonary veins, and at a distance from the roof line (red dots). The electrode used as reference is seen at the level of the interventricular septum.

This technique allows continuous visualization of the esophageal position; hence, the operator can avoid application of radiofrequency in the vicinity of the esophagus or reduce the potency and duration of application. Esophageal displacement caused by peristaltic movements, respiration, etc, are monitored in real time. Esophageal lesions and atrioesophageal fistula can be easily averted with this approach. The main advantage with respect to other recently reported techniques is that there is no need for a flexible urethral catheter for electrode insertion. This simplifies the procedure and allows free movement of the catheter within the esophagus. A relevant limitation, apart from those inherent to the navigation system (risk of map displacement, what you see is not "real" but only mapped anatomy) is the fact that the true dimensions and anatomic limitations of the esophagus are not visualized.

Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.