Relationship between the posterior atrial wall and the esophagus: esophageal position during atrial fibrillation ablation

Teres, Cheryl; Soto-Iglesias, David; Penela, Diego; Jáuregui, Beatriz; Ordoñez, Augusto; Chauca, Alfredo; Carreño, Jose Miguel; Scherer, Claudia; Huguet, Marina; Ramírez, Carlos; Torres Mandujano, José; Maldonado, Giuliana; Panaro, Alejandro; Carballo, Julio; Camara, Oscar; Ortiz-Pérez, Jose-Tomás; Berruezo, Antonio

doi:http://dx.doi.org/10.1016/j.hroo.2022.02.007

Relationship between the posterior atrial wall and the esophagus: esophageal position during atrial fibrillation ablation

Citation

Teres C, Soto-Iglesias D, Penela D, Jáuregui B, Ordoñez A, Chauca A, Carreño JM, Scherer C, Huguet M, Ramírez C, Torres Mandujano J, Maldonado G, Panaro A, Carballo J, Cámara Ó, Ortiz-Pérez JT, Berruezo A. Relationship between the posterior atrial wall and the esophagus: esophageal position during atrial fibrillation ablation. Heart Rhythm O2. 2022;3(3):252-60. DOI: 10.1016/j.hroo.2022.02.007

Abstract

BACKGROUND Atrial fibrillation ablation implies a risk of esophageal thermal injury. Esophageal position can be analyzed with imaging techniques, but evidence for esophageal mobility is inconsistent. OBJECTIVES The purpose of this study was to analyze esophageal position stability from one procedure to another and during a single procedure. METHODS Esophageal position was compared in 2 patient groups. First, preprocedural multidetector computerized tomography (MDCT) of first pulmonary vein isolation and redo intervention (redo group) was segmented with ADAS 3D to compare the stability of the atrioesophageal isodistance prints. Second, 3 imaging modalities were compared for the same procedure (multimodality group): (1) preprocedural MDCT; (2) intraprocedural fluoroscopy obtained with the transesophageal echocardiographic probe in place with CARTOUNIVU; and (3) esophageal fast anatomic map (FAM) at the end of the procedure. Esophageal position correlation between different imaging techniques was computed in MATLAB using semiautomatic segmentation analysis.