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Evaluation of periesophageal nerve injury after pulmonary vein isolation using the (13)C-acetate breath test

BACKGROUND: Pulmonary vein isolation (PVI) has become an important option for treating patients with atrial fibrillation (AF). Periesophageal nerve (PEN) injury after PVI causes pyloric spasms and gastric hypomotility. This study aimed to clarify the impact of PVI on gastric motility and assess the...

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Autores principales: Kanaeda, Tomonori, Ueda, Marehiko, Arai, Makoto, Ishimura, Masayuki, Kajiyama, Takatsugu, Hashiguchi, Naotaka, Nakano, Masahiro, Kondo, Yusuke, Hiranuma, Yasunori, Oyamada, Arata, Yokosuka, Osamu, Kobayashi, Yoshio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672080/
https://www.ncbi.nlm.nih.gov/pubmed/26702316
http://dx.doi.org/10.1016/j.joa.2015.06.004
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author Kanaeda, Tomonori
Ueda, Marehiko
Arai, Makoto
Ishimura, Masayuki
Kajiyama, Takatsugu
Hashiguchi, Naotaka
Nakano, Masahiro
Kondo, Yusuke
Hiranuma, Yasunori
Oyamada, Arata
Yokosuka, Osamu
Kobayashi, Yoshio
author_facet Kanaeda, Tomonori
Ueda, Marehiko
Arai, Makoto
Ishimura, Masayuki
Kajiyama, Takatsugu
Hashiguchi, Naotaka
Nakano, Masahiro
Kondo, Yusuke
Hiranuma, Yasunori
Oyamada, Arata
Yokosuka, Osamu
Kobayashi, Yoshio
author_sort Kanaeda, Tomonori
collection PubMed
description BACKGROUND: Pulmonary vein isolation (PVI) has become an important option for treating patients with atrial fibrillation (AF). Periesophageal nerve (PEN) injury after PVI causes pyloric spasms and gastric hypomotility. This study aimed to clarify the impact of PVI on gastric motility and assess the prevalence of gastric hypomotility after PVI. METHODS: Thirty consecutive patients with AF underwent PVI under luminal esophageal temperature (LET) monitoring. The (13)C-acetate breath test was conducted before and after the procedure for all patients (PVI group). Gastric emptying was evaluated using the time to peak concentration of (13)CO(2) (T(max)). This test was also conducted in another 20 patients who underwent catheter ablation procedures other than PVI (control group). RESULTS: The number of patients with abnormal T(max) (≥75 min) increased from seven (23%) to 13 (43%) and from three (15%) to five (25%) after the procedure in the PVI group and control group, respectively. The mean T(max) was longer after PVI than before PVI (64±14 min vs. 57±15 min, p=0.006), whereas there was no significant difference before and after the procedure in the control group. However, no significant difference in ΔT(max) was observed between the two groups (p=0.27). No patients suffered from symptomatic gastric hypomotility. CONCLUSIONS: Asymptomatic gastric hypomotility occurred more often after PVI. However, the average impact of PVI on gastric motility was minimal.
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spelling pubmed-46720802015-12-23 Evaluation of periesophageal nerve injury after pulmonary vein isolation using the (13)C-acetate breath test Kanaeda, Tomonori Ueda, Marehiko Arai, Makoto Ishimura, Masayuki Kajiyama, Takatsugu Hashiguchi, Naotaka Nakano, Masahiro Kondo, Yusuke Hiranuma, Yasunori Oyamada, Arata Yokosuka, Osamu Kobayashi, Yoshio J Arrhythm Original Article BACKGROUND: Pulmonary vein isolation (PVI) has become an important option for treating patients with atrial fibrillation (AF). Periesophageal nerve (PEN) injury after PVI causes pyloric spasms and gastric hypomotility. This study aimed to clarify the impact of PVI on gastric motility and assess the prevalence of gastric hypomotility after PVI. METHODS: Thirty consecutive patients with AF underwent PVI under luminal esophageal temperature (LET) monitoring. The (13)C-acetate breath test was conducted before and after the procedure for all patients (PVI group). Gastric emptying was evaluated using the time to peak concentration of (13)CO(2) (T(max)). This test was also conducted in another 20 patients who underwent catheter ablation procedures other than PVI (control group). RESULTS: The number of patients with abnormal T(max) (≥75 min) increased from seven (23%) to 13 (43%) and from three (15%) to five (25%) after the procedure in the PVI group and control group, respectively. The mean T(max) was longer after PVI than before PVI (64±14 min vs. 57±15 min, p=0.006), whereas there was no significant difference before and after the procedure in the control group. However, no significant difference in ΔT(max) was observed between the two groups (p=0.27). No patients suffered from symptomatic gastric hypomotility. CONCLUSIONS: Asymptomatic gastric hypomotility occurred more often after PVI. However, the average impact of PVI on gastric motility was minimal. Elsevier 2015-12 2015-07-14 /pmc/articles/PMC4672080/ /pubmed/26702316 http://dx.doi.org/10.1016/j.joa.2015.06.004 Text en © 2015 Japanese Heart Rhythm Society. Published by Elsevier B.V. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Kanaeda, Tomonori
Ueda, Marehiko
Arai, Makoto
Ishimura, Masayuki
Kajiyama, Takatsugu
Hashiguchi, Naotaka
Nakano, Masahiro
Kondo, Yusuke
Hiranuma, Yasunori
Oyamada, Arata
Yokosuka, Osamu
Kobayashi, Yoshio
Evaluation of periesophageal nerve injury after pulmonary vein isolation using the (13)C-acetate breath test
title Evaluation of periesophageal nerve injury after pulmonary vein isolation using the (13)C-acetate breath test
title_full Evaluation of periesophageal nerve injury after pulmonary vein isolation using the (13)C-acetate breath test
title_fullStr Evaluation of periesophageal nerve injury after pulmonary vein isolation using the (13)C-acetate breath test
title_full_unstemmed Evaluation of periesophageal nerve injury after pulmonary vein isolation using the (13)C-acetate breath test
title_short Evaluation of periesophageal nerve injury after pulmonary vein isolation using the (13)C-acetate breath test
title_sort evaluation of periesophageal nerve injury after pulmonary vein isolation using the (13)c-acetate breath test
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4672080/
https://www.ncbi.nlm.nih.gov/pubmed/26702316
http://dx.doi.org/10.1016/j.joa.2015.06.004
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