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

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Catheter Ablation
Coronary Sinus
Esophagus
Atrial Fibrillation
Multidetector Computed Tomography
Heart Atria
Veins
Hot Temperature

Keywords

  • Ablation
  • Coronary sinus
  • Esophagus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Anatomic proximity of the esophagus to the coronary sinus : Implication for catheter ablation within the coronary sinus. / Tsao, Hsuan Ming; Wu, Mei Han; Chern, Ming Sheng; Tai, Ching Tai; Lin, Yenn Jiang; Chang, Shih Lin; Chiang, Shuo Ju; Ong, Mary Gertrude; Wongcharoen, Wanwarang; Hsu, Nai Wei; Chang, Cheng Yen; Chen, Shih Ann.

In: Journal of Cardiovascular Electrophysiology, Vol. 17, No. 3, 03.2006, p. 266-269.

Research output: Contribution to journalArticle

Tsao, HM, Wu, MH, Chern, MS, Tai, CT, Lin, YJ, Chang, SL, Chiang, SJ, Ong, MG, Wongcharoen, W, Hsu, NW, Chang, CY & Chen, SA 2006, 'Anatomic proximity of the esophagus to the coronary sinus: Implication for catheter ablation within the coronary sinus', Journal of Cardiovascular Electrophysiology, vol. 17, no. 3, pp. 266-269. https://doi.org/10.1111/j.1540-8167.2006.00353.x
Tsao, Hsuan Ming ; Wu, Mei Han ; Chern, Ming Sheng ; Tai, Ching Tai ; Lin, Yenn Jiang ; Chang, Shih Lin ; Chiang, Shuo Ju ; Ong, Mary Gertrude ; Wongcharoen, Wanwarang ; Hsu, Nai Wei ; Chang, Cheng Yen ; Chen, Shih Ann. / Anatomic proximity of the esophagus to the coronary sinus : Implication for catheter ablation within the coronary sinus. In: Journal of Cardiovascular Electrophysiology. 2006 ; Vol. 17, No. 3. pp. 266-269.
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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.",
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T2 - Implication for catheter ablation within the coronary sinus

AU - Tsao, Hsuan Ming

AU - Wu, Mei Han

AU - Chern, Ming Sheng

AU - Tai, Ching Tai

AU - Lin, Yenn Jiang

AU - Chang, Shih Lin

AU - Chiang, Shuo Ju

AU - Ong, Mary Gertrude

AU - Wongcharoen, Wanwarang

AU - Hsu, Nai Wei

AU - Chang, Cheng Yen

AU - Chen, Shih Ann

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N2 - 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.

AB - 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.

KW - Ablation

KW - Coronary sinus

KW - Esophagus

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