1. Fecal calprotectin: A novel predictor of ulcerated esophageal injury after atrial fibrillation catheter ablation.
- Author
-
Wang, Yun‐He, Tang, Xiao‐Mei, Jiang, Ru‐Hong, Sun, Ya‐Xun, Liu, Qiang, Zhang, Pei, Yu, Lu, Lin, Jian‐Wei, Cheng, Hui, Chen, Shi‐Quan, Zhang, Zu‐Wen, Sheng, Xia, Lin, Ne, Chen, Xiao‐Li, Fu, Guo‐Sheng, and Jiang, Chen‐Yang
- Subjects
ESOPHAGEAL injuries ,ANTIGEN analysis ,FECAL analysis ,ULCERS ,PREDICTIVE tests ,ESOPHAGEAL fistula ,INFLAMMATION ,RADIO frequency therapy ,ENDOSCOPIC ultrasonography ,ATRIAL fibrillation ,CATHETER ablation ,SURGICAL complications ,RISK assessment ,DESCRIPTIVE statistics ,ESOPHAGUS diseases ,RECEIVER operating characteristic curves ,SENSITIVITY & specificity (Statistics) ,PULMONARY veins ,LONGITUDINAL method ,DISEASE risk factors - Abstract
Background: Atrial esophageal fistula (AEF) is a lethal complication that can occur post atrial fibrillation (AF) ablation. Esophageal injury (EI) is likely to be the initial lesion leading to AEF. Endoscopic examination is the gold standard for a diagnosis of EI but extensive endoscopic screening is invasive and costly. This study was conducted to determine whether fecal calprotectin (Fcal), a marker of inflammation throughout the intestinal tract, may be associated with the existence of esophageal injury. Methods: This diagnostic study was conducted in a cohort of 166 patients with symptomatic AF undergoing radiofrequency catheter ablation from May 2020 to June 2021. Fcal tests were performed 1–7 days after ablation. All patients underwent endoscopic ultrasonography 1 or 2 days after ablation. Results: The levels of Fcal were significantly different between the EI and non‐EI groups (404.9 µg/g (IQR 129.6–723.6) vs. 40.4 µg/g (IQR 15.0–246.2), p <.001). Analysis of ROC curves revealed that a Fcal level of 125 µg/g might be the optimal cut‐off value for a diagnosis of EI, giving a 78.8% sensitivity and a 65.4% specificity. The negative predictive value of Fcal was 100% for ulcerated EI. Conclusions: The level of Fcal is associated with EI post AF catheter ablation. 125 µg/g might be the optimal cut‐off value for a diagnosis of EI. Negative Fcal could predict the absence of ulcerated EI, which could be considered a precursor to AEF. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF