Esophageal Injury Risk Factors in Patients With Atrial Fibrillation Undergoing Catheter Ablation

Area of Science:

• Cardiology
• Gastroenterology
• Medical Complications

Background:

• Esophageal injury (EI) is a serious potential complication of catheter ablation (CA) for atrial fibrillation (AF).
• Limited data exist on EI incidence and risk factors after radiofrequency catheter ablation (RFCA) and cryoballoon ablation (CBA).

Purpose of the Study:

• To identify predictors of esophageal injury in patients undergoing RFCA and CBA for AF.

Main Methods:

• Retrospective evaluation of 584 AF patients undergoing de novo RFCA or CBA.
• Esophagogastroduodenoscopy (EGD) performed within 2 days post-ablation.
• Analysis of clinical predictors using multivariate logistic regression.

Main Results:

• 30 patients (5.1%) developed EI; most injuries were mild (Class I) and resolved with treatment.
• Patients with EI had significantly lower body mass index (BMI) and reduced ejection fraction (EF).
• Independent risk factors identified: BMI ≤ 24 kg/m² (OR, 3.67) and EF ≤ 40% (OR, 4.08).

Conclusions:

• Esophageal injury after AF ablation is not rare but usually mild.
• Lower BMI and reduced LVEF are independent risk factors for EI, irrespective of ablation technique.
• Selective endoscopic screening in high-risk patients is recommended for early detection and prevention of severe complications.