AUTHOR=Miyazaki Shinsuke , Kobori Atsushi , Jo Hikari , Keida Takehiko , Yoshitani Kazuyasu , Mukai Moe , Sagawa Yuichiro , Asakawa Tetsuya , Sato Eiji , Yamao Kazuya , Horie Tomoki , Manita Mamoru , Fukaya Hidehira , Hayashi Hidemori , Tanimoto Kojiro , Iwayama Tadateru , Chiba Suguru , Sato Akinori , Sekiguchi Yukio , Sugiura Kenta , Iwai Shinsuke , Isonaga Yuhei , Miwa Naoyuki , Kato Nobutaka , Inaba Osamu , Hirota Takayoshi , Nagata Yasutoshi , Ono Yuichi , Hachiya Hitoshi , Yamauchi Yasuteru , Goya Masahiko , Nitta Junichi , Tada Hiroshi , Sasano Tetsuo TITLE=Symptomatic periesophageal vagal nerve injury by different energy sources during atrial fibrillation ablation JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=10 YEAR=2023 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1278603 DOI=10.3389/fcvm.2023.1278603 ISSN=2297-055X ABSTRACT=Background

Symptomatic gastric hypomotility (SGH) is a rare but major complication of atrial fibrillation (AF) ablation, but data on this are scarce.

Objective

We compared the clinical course of SGH occurring with different energy sources.

Methods

This multicenter study retrospectively collected the characteristics and clinical outcomes of patients with SGH after AF ablation.

Results

The data of 93 patients (67.0 ± 11.2 years, 68 men, 52 paroxysmal AF) with SGH after AF ablation were collected from 23 cardiovascular centers. Left atrial (LA) ablation sets included pulmonary vein isolation (PVI) alone, a PVI plus a roof-line, and an LA posterior wall isolation in 42 (45.2%), 11 (11.8%), and 40 (43.0%) patients, respectively. LA ablation was performed by radiofrequency ablation, cryoballoon ablation, or both in 38 (40.8%), 38 (40.8%), and 17 (18.3%) patients, respectively. SGH diagnoses were confirmed at 2 (1–4) days post-procedure, and 28 (30.1%) patients required re-hospitalizations. Fasting was required in 81 (92.0%) patients for 4 (2.5–5) days; the total hospitalization duration was 11 [7–19.8] days. After conservative treatment, symptoms disappeared in 22.3% of patients at 1 month, 48.9% at 2 months, 57.6% at 3 months, 84.6% at 6 months, and 89.7% at 12 months, however, one patient required surgery after radiofrequency ablation. Symptoms persisted for >1-year post-procedure in 7 patients. The outcomes were similar regardless of the energy source and LA lesion set.

Conclusions

The clinical course of SGH was similar regardless of the energy source. The diagnosis was often delayed, and most recovered within 6 months, yet could persist for over 1 year in 10%.