Journal of cardiovascular electrophysiology
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J. Cardiovasc. Electrophysiol. · Jul 2009
Randomized Controlled TrialEsophageal damage during radiofrequency ablation of atrial fibrillation: impact of energy settings, lesion sets, and esophageal visualization.
Atrioesophageal fistula is an uncommon but often lethal complication of atrial fibrillation (AF) ablation. The purpose of our study was to prospectively investigate the incidence of esophageal ulcerations (ESUL) as well as the impact of energy settings, radiofrequency lesion sets, and direct visualization of the esophagus on esophageal wall injury. ⋯ ESUL is a rare finding when using a reasonable energy maximum of 25 W with open-irrigated tip catheters at the posterior wall. Lower energy settings may increase safety without losing efficacy. Additional linear radiofrequency lesions increase the risk of ESUL development.
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J. Cardiovasc. Electrophysiol. · Jul 2009
Case ReportsTachycardia-induced right ventricular cardiomyopathy: epicardial radiofrequency ablation of an unusual and unexpected ventricular tachycardia.
A 38-year-old man without prior medical history was hospitalized for sustained monomorphic ventricular tachycardia (VT) left bundle branch block pattern with inferior QRS axis resistant to beta blockers. Right ventricular (RV) ejection fraction (EF) was 28%. Left ventricular EF was normal. ⋯ Percutaneous epicardial radiofrequency application at the lateral mitral annulus was successful. The RVEF later normalized. Some VTs originating from the left ventricular epicardium are potential mimickers of benign VTs originating from the ventricular outflow tract (right or left) or arrhythmogenic right ventricular cardiomyopathy VT and they may induce isolated RV dysfunction.