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Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation

Ablation of the left atrium using either radiofrequency (RF) or cryothermal energy is an effective treatment for atrial fibrillation (AF) and is the most ...

University of London

Protamine sulfate is commonly used to reverse the action of heparin after catheter ablation procedures. Serious protamine-related adverse effect is rare, but its recognition and appropriate management by electrophysiologists and intensivists is important. Direct ventricular fibrillation (VF) soon after a slow infusion of protamine has not been clearly described.

Cardiac arrest following protamine administration: a case series.

Satisfactory left ventricular (LV) lead placement into the coronary sinus (CS) can be achieved in the majority of patients but there are still instances of acute failure most often due to anatomical differences, for example due to tortuous CS anatomy. Chronic LV lead misplacement and its delayed discovery is not a common scenario. It is unclear if chronic dual right ventricular pacing can hasten the progression of heart failure.

Left ventricular lead misplacement discovered a decade after cardiac resynchronization therapy-defibrillator implantation: a case report.

Peri-procedural transoesophageal echocardiography (TOE) is important in monitoring and minimizing major complications during pacing lead extraction. It is a widely accepted precautionary measure, especially in extractions considered to be higher risk. Pacing lead extraction may be challenging, and it is associated with significant risk of major bleeding from vascular trauma.

Lisa W. M. Leung

St George's University Hospitals NHS Foundation Trust,
St. George's,
St George's University Hospitals NHS Foundation Trust, St. George's

University of London

Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation

Lisa W. M. Leung

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University of London

Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation

St George's University Hospitals NHS Foundation Trust,
St. George's,
St George's University Hospitals NHS Foundation Trust, St. George's