Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Quality Measures & Complications D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-158 - Incidental Endoscopic Findings In The Made-PVI Trial: Pre-procedural Proton Pump Inhibition Is Associated With Fewer Peri-esophageal Lesions After Cryoballoon Pulmonary Vein Isolation (ID 944)


Background: Cryoballoon ablation is established for achieving pulmonary vein isolation (PVI) for treatment of atrial fibrillation (AF). Diseases of the upper gastrointestinal (GI) tract increase the risk for AF. The incidence and the impact of upper GI pathologies on safety in cryoballoon ablation have not been investigated so far.
Objective: To assess incidental pathologies of the upper GI tract in patients scheduled for cryoballoon PVI and to determine their influence on PVI safety outcome.
Methods: Esophagogastroduodenoscopy and endosonography were prospectively performed in 71 patients who participated in the MADE-PVI (Mediastino-esophageal Alterations Detected by Endosonography after PVI) trial. Examinations were performed directly before and the day after PVI to evaluate pre-existing upper GI pathologies and occurrence of PVI-associated lesions.
Results: Clinically relevant incidental findings were observed in 35 patients (49%). Age>50 years was associated with more incidental findings (p=0.007). Pre-existing reflux esophagitis increased the risk for PVI-associated mediastinal edema (p=0.041), while patients already treated with proton pump inhibitors (n=14) had significantly fewer mediastinal lesions (p=0.036).
Conclusion: Pre-existing reflux esophagitis increases the risk for PVI-associated mediastinal edema, while constant treatment with proton pump inhibitors prior to PVI is associated with fewer mediastinal lesions. Our findings indicate a beneficial effect of pre-interventional prophylactic PPI-treatment to reduce risk for PVI-associated complications.