RESUMO
BACKGROUND: Real-time esophageal imaging is critical in avoiding esophageal injury. However, the safety of esophageal imaging with barium has not been specifically explored. METHODS: Three hundred seventy consecutive patients underwent left atrial (LA) ablation of atrial fibrillation (AF) under conscious sedation. One hundred eighty-five patients (50%) underwent the ablation procedure with, and 185 patients (50%) underwent the procedure without administration of barium. Fever, as a surrogate for aspiration, was defined as a maximal temperature >or=100 degrees F within the first 24 hours following the ablation procedure. RESULTS: Thirty of the 370 patients (8%) developed fever within 24 hours after LA ablation. The prevalence of fever was 9% (17/185) among patients who received barium and 7% (13/185) among those who did not receive barium (P = 0.6). Evaluation revealed the following causes of fever in 14 of the 30 patients (47%) with no difference in prevalence between the 2 groups: pericarditis, venous thromboembolism, hematoma, and infiltrate on chest radiography. Multivariate analysis failed to reveal any factors associated with development of fever. None of the patients experienced serious complications such as respiratory failure or atrioesophageal fistula. CONCLUSIONS: Fever may occur in approximately 10% of patients undergoing LA ablation of AF. Administration of barium is not associated with fever or other complications such as aspiration pneumonia. Real-time imaging of the esophagus with barium administration in conjunction with conscious sedation appears to be safe.
Assuntos
Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/cirurgia , Radioisótopos de Bário , Ablação por Cateter/efeitos adversos , Esofagoscopia/efeitos adversos , Febre/epidemiologia , Adulto , Idoso , Fibrilação Atrial/fisiopatologia , Ablação por Cateter/métodos , Esofagoscopia/métodos , Feminino , Febre/etiologia , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Radiografia , Estudos RetrospectivosRESUMO
In this issue of Congestive Heart Failure, the editor of this department addresses a topic on which there is conflicting data. Dr Tepper selected 2 of the most relevant abstracts for review. His comments on the conflicting data-and the polarized viewpoints among physicians that often result-provide insights on the clinical implications of the controversy.