Demonstration of Periesophageal Nerve Injury after

Demonstration of Periesophageal Nerve Injury after Pulmonary Vein Isolation Using a
13
C-Acetate Breath Test
13
( C 酢酸呼気テストを用いた肺静脈隔離術後の傍食道神経傷害の検討)
要約
千葉大学医学大学院医学薬学府
環境健康科学専攻
循環器病態学
(主任：小林欣夫教授)
金枝
朋宜
0
ABSTRACT
Introduction
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 and Results
Thirty consecutive patients with AF underwent PVI under luminal esophageal
temperature (LET) monitoring. The
13C-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
13CO2 (Tmax).
The test was also conducted in
another 20 patients who underwent catheter ablation procedures other than PVI
(control group).
The number of patients with abnormal Tmax (>60 min) increased from 7 (23%) to 13
(43%) and from 3 (15%) to 5 (25%) after the procedure in the PVI group and control
group, respectively. The mean Tmax 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 Δ
Tmax was observed between the two groups (P = 0.27). No patient suffered from
symptomatic gastric hypomotility.
Conclusions
Asymptomatic gastric hypomotility occurred most frequently after PVI. However,
the average impact of PVI on gastric motility under monitoring of LET was minimal
Key words
atrial fibrillation; pulmonary vein isolation; periesophageal nerve; luminal
esophageal temperature monitoring; 13C-acetate breath test; gastric emptying
1
Heart Rhythm
平成 25 年 10 月
投稿中
2

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