The Application Of Ultrasonic Gastroscope In Patients With Atrial Fibrallation Following Ablation

BackgroundAtrial-esophageal fistula(AEF)is a life-threatening complication caused by ablaltion therapy which is increasingly performed to suppress the atrial fibrillation(AF).ObjectiveThe purpose of this study was to evaluate the security and validity of esophagogastroduodenoscopy(EGD)combined with ultrasound gastroscopy(EUS),simutaneously,explore esophatrial lesions and mediastinal connective tissue with different ablation methods.MethodsThis was a single-center retrospective study included one hundred and forty-nine patients hospitalized for atrial fibrillation who underwent cathter ablation between July 2013 and September 2017.Ablation therapy was implemented by radiofrequency ablation(RFCA)in 85 patients,cryoablation(CYRO)in 45 patients and AF combining cryoablation(RAC)in 19 patients.Patients received EGD together with EUS after ablation therapy within one week.ResultsEsophageal lesions were observed in 39 patients(26.2%,erythema/erosion n=29,hematoma n=7,ulcer n=3).Endoscopic ultrasound demonstrated mediastinal effusions in 54 patients(36.2%)and esophageal wall thickenings in 25 patients.20 out of 25 patients(80%)existed mediastinal effusions and 16 out of 25(64%)had adjacent esophageal alterations,including all three patients with uclers.However,the occurrence were 27.4%(P<0.05)and 18.5%(P<0.05)respectively in patients without thickened esophageal walls.There was no significant difference between patients with and without esophageal lesions in the rate of mediastinal fluid.But a higher remarkably percentage of esophageal wall thickenings was identified in patients with esophageal changing.Female,preoperative esophageal ultrasonography and esophageal lesions influenced esophageal thickenings in bivariate logistic regression analyses.No adverse events were reported during follow-up(mean,837±569 days).Conclusions:Endosonography might be a sensitive and safe tool to recognize high risk groups with esophageal wall thickening in patients having esophageal lesions.Female,and preoperative esophageal ultrasonography associated with a higher probability of thickened esophageal wall.