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Photodynamic therapy for Barrett's esophagus: cardiac effects
B F Overholt1, M Panjehpour, M Ayres
1Laser Center, Thompson Cancer Survival Center, Knoxville, Tennessee, USA.
Background And Objective:
Atrial fibrillation has been reported following esophageal photodynamic therapy. This study presents the results of serial cardiac testing following photodynamic therapy for patients with Barrett's esophagus and with dysplasia or early carcinoma.
Study Design/Materials And Methods:
Twelve patients were treated using photodynamic therapy. Serum creatinine phosphokinase and lactic dehydrogenase isoenzyme levels were determined pretreatment and 24, 48, and 72 hours after treatment. Electrocardiograms were obtained before and 48 hours after treatment. A rhythm strip was obtained 1 week posttreatment. Clinical assessment for cardiac arrhythmias occurred daily following therapy.
Results:
Transient atrial fibrillation was noted in one patient during a follow-up endoscopy. However, no significant or permanent abnormality was noted in cardiac enzymes or electrocardiograms.
Conclusion:
No permanent electrocardiographic changes or significant abnormalities in cardiac enzymes were detected following esophageal photodynamic therapy in patients with or without histories of cardiac disease. Delivery of esophageal PDT is not associated with permanent adverse cardiac effects.