Esophageal contraction during cryoablation: A possible protective mechanism

• Published in: Pacing and clinical electrophysiology 2020-09, Vol.43 (9), p.908-912
• Main Authors: Cai, Dongsheng, Liu, Qiang, Shehata, Michael, Jiang, Ruhong, Yu, Lu, Zhang, Pei, Sun, Yaxun, Chen, Shiquan, Zhang, Zuwen, Fu, Guosheng, Jiang, Chenyang, Wang, Xunzhang
• Format: Article
• Language: English
• Subjects: atrial fibrillation; Cardiac arrhythmia; cryoballoon ablation; Endoscopy; esophageal injury; Esophagus; Fibrillation; Freezing; Lungs
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/pace.13967

Background Contraction of the esophagus was observed during cryoablation for paroxysmal atrial fibrillation (PAF). The purpose of this study is to investigate the mechanism of esophageal contraction and the correlation between the contraction and esophageal thermal lesions. Methods This prospective study enrolled 64 patients with PAF undergoing second‐generation cryoballoon (CB2) ablation for pulmonary vein isolation (PVI). During PVI for the left inferior pulmonary vein, contrast esophagography was performed before and during cryoablation. The sample population was divided into two groups: A (31 patients) and B (33 patients). Group A consisted of patients in whom the distal half of the CB was in proximity to the esophagus, while for group B the esophagus was away from the distal half of the CB. Esophageal contraction was recorded as a variation in the width of the esophageal lumen during PVI. Postablation esophageal endoscopy was done on all patients. Results The reduction in the width of the esophageal lumen in group A was greater than in group B during freezing (40.12 ± 23.24% vs 8.14 ± 10.35%, P