Abstract
Introduction: Gastric hypomotility (GH) is a major complication
of atrial fibrillation (AF) ablation. We aimed to clarify whether
additional cryoballoon ablation (CBA) of the left atrial (LA) roof is
associated with GH.
Methods and Results: This study included 54 patients with
non-paroxysmal AF who underwent CBA for pulmonary vein isolation and of
the LA roof line. GH was defined according to the results of
esophagogastroscopy performed 2 days after ablation. GH was observed in
10 patients. There were significant differences in LA diameter (LAD),
right inferior pulmonary vein (RIPV) diameter, and the height of the LA
roof from the point where the LA posterior wall and esophagus make
contact between patients with (GH+) and without GH (GH–) (LAD: 41.0
[36.3–41.8] mm vs. 46.5 [42.8–50.0] mm, p<0.01; RIPV
diameter: 19.7 [19.0–20.5] mm vs. 23.2 [21.2–24.9] mm,
p<0.01; height of LA roof: 5.7 [5.1–6.1] mm vs. 8.8
[7.1–11.2] mm for, p<0.01, respectively). Multivariate
analysis revealed that LA roof height was a predictor of GH. Moreover,
Patient Assessment of Upper Gastrointestinal Disorders-Symptom Severity
Index (PAGI-SYM) scores increased significantly 1 week after ablation
(from 1.0 [0.0–2.8] to 5.0 [3.0–11.0], p=0.03) in patients
with GH.
Conclusion: The height of the LA roof may be a predictor of GH
after CBA of the LA roof line. Additionally, GH-related symptoms may
still appear 1 week after ablation.
Keywords: Ablation, Atrial fibrillation, Cryoballoon, Gastric
hypomotility, Roof line