A Novel Finding

– Impairment of Gastric Myoelectricity After Catheter Ablation of Atrial Fibrillation –

Abstract

Background: Dyspepsia is not uncommon in patients undergoing ablation of atrial fibrillation (AF). The purpose of this study was to investigate the change in gastric myoelectrical activity and its relationship to the outcome after ablation by electrogastrography (EGG). Methods and Results: The study prospectively enrolled 32 patients: 16 patients (Group 1) had AF and 16 (Group 2) had paroxysmal supraventricular tachycardia. The myoelectricity-like signals of the gastrointestinal tract were recorded using EGG before, immediately, and 3 months after ablation. Both fasting and postprandial abnormal gastric wave percentages increased immediately after ablation in Group 1 when compared with before ablation. Increased fasting (12.8±15.2% vs. 22.3±21.0%, P=0.04) and postprandial (10.4±6.2% vs. 21.2±14.5%, P=0.01) bradygastria percentages were noted immediately after ablation in Group 1 when compared with before ablation. These findings were not observed in Group 2. The normal gastric wave percentage returned to baseline 3 months after procedure. In total, 4 (25%) patients in Group 1 had a recurrence of AF after a follow-up of 18±3 months; those without recurrence had a significantly higher percentage of postprandial abnormal gastric waves immediately after ablation when compared with recurrence. Conclusions: Transient gastric dysrhythmias with bradygastria does occur in AF patients after ablation, which may indicate periesophageal vagal plexus damage after ablation. Careful application of radiofrequency energy to prevent esophageal injury is important.  (Circ J 2013; 77: 2014–2023)