Anatomic proximity of the esophagus to the coronary sinus: Implication for catheter ablation within the coronary sinus

Hsuan Ming Tsao, Mei Han Wu, Ming Sheng Chern, Ching Tai Tai, Yenn Jiang Lin, Shih Lin Chang, Shuo Ju Chiang, Mary Gertrude Ong, Wanwarang Wongcharoen, Nai Wei Hsu, Cheng Yen Chang, Shih Ann Chen

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Introduction: The anatomic proximity between the esophagus and the coronary sinus (CS) might render the esophagus vulnerable to thermal injury during ablation. Therefore, we investigated the anatomic relationship between the esophagus and the CS in patients with atrial fibrillation (AF). Methods and Results: Thirty patients (25 males, mean age = 54 ± 11 years) with drug-refractory paroxysmal AF were included. Sixteen-slice multidetector computed tomography was performed to depict the course of the esophagus and relationship to the CS. The esophagus was in direct contact with the CS in 57% (17/30) of patients (group 1). The mean length of the contact was 6.1 ± 3.4 mm. In the remaining 13 patients, the esophagus did not come in direct contact with the CS (group 2). The shortest distance between the esophagus and the CS was 4.0 ± 2.6 mm. The CS diameter (9.4 ± 1.8 vs 8.5 ± 2.4 mm, P = 0.15), esophagus width (18.6 ± 1.6 vs 18.6 ± 1.7 mm, P = 0.87), anteroposterior diameter of the left atrium (35.9 ± 3.8 vs 35.0 ± 3.3 mm, P = 0.58), thickness of the anterior wall of the esophagus (2.9 ± 0.6 vs 2.9 ± 0.6 mm, P = 0.97), and shortest distance from the esophagus to the CS ostium (19.3 ± 5.4 vs 25.0 ± 6.2 mm, P = 0.02) and to the great cardiac vein (8.5 ± 5.3 vs 12.1 ± 6.9 mm, P = 0.10) were compared between the two groups. Conclusions: In 57% of our patients, the esophagus was in direct contact with the CS, and a significantly shorter distance between the esophagus and the CS ostium was noted in these patients. It is important to prevent esophageal damage when applying energy within the CS.

Original languageEnglish
Pages (from-to)266-269
Number of pages4
JournalJournal of Cardiovascular Electrophysiology
Volume17
Issue number3
DOIs
Publication statusPublished - Mar 2006
Externally publishedYes

Keywords

  • Ablation
  • Coronary sinus
  • Esophagus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

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  • Cite this

    Tsao, H. M., Wu, M. H., Chern, M. S., Tai, C. T., Lin, Y. J., Chang, S. L., Chiang, S. J., Ong, M. G., Wongcharoen, W., Hsu, N. W., Chang, C. Y., & Chen, S. A. (2006). Anatomic proximity of the esophagus to the coronary sinus: Implication for catheter ablation within the coronary sinus. Journal of Cardiovascular Electrophysiology, 17(3), 266-269. https://doi.org/10.1111/j.1540-8167.2006.00353.x