PMID- 33633186
OWN - NLM
STAT- MEDLINE
DCOM- 20211210
LR  - 20211214
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 11
IP  - 1
DP  - 2021 Feb 25
TI  - Pre-procedural proton pump inhibition is associated with fewer peri-oesophageal 
      lesions after cryoballoon pulmonary vein isolation.
PG  - 4728
LID - 10.1038/s41598-021-83928-0 [doi]
LID - 4728
AB  - Pulmonary vein isolation (PVI) using cryoenergy is safe and efficient for 
      treatment of atrial fibrillation (AF). Pre-existing upper gastrointestinal (GI) 
      pathologies have been shown to increase the risk for AF. Therefore, this study 
      aimed at assessing incidental pathologies of the upper GI tract in patients 
      scheduled for PVI and to analyse the impact of patients' characteristics on PVI 
      safety outcome. In 71 AF patients, who participated in the MADE-PVI trial, 
      oesophagogastroduodenoscopy and endosonography were prospectively performed 
      directly before and the day after PVI to assess pre-existing upper GI pathologies 
      and post-interventional occurrence of PVI-associated lesions. Subgroup analysis 
      of the MADE-PVI trial identified clinically relevant incidental findings in 53 
      patients (74.6%) with age > 50 years being a significant risk factor. 
      Pre-existing reflux oesophagitis increased risk for PVI-associated mediastinal 
      oedema, while patients already treated with proton pump inhibitors (PPI) had 
      significantly fewer mediastinal oedema. Our results suggest that AF patients with 
      pre-existing reflux oesophagitis are at higher risk for PVI-associated 
      mediastinal lesions, which is decreased in patients with constant PPI-treatment 
      prior to PVI. Since PVI-associated mediastinal lesions are regarded as surrogate 
      parameter for an increased risk of the fatal complication of an oesophago-atrial 
      fistula, our findings hint at a beneficial effect of pre-interventional 
      prophylactic PPI-treatment to reduce risk for PVI-associated complications.German 
      Clinical Trials Register (DRKS00016006; date of registration: 17/12/2018).
FAU - Cordes, F
AU  - Cordes F
AUID- ORCID: 0000-0002-0376-0764
AD  - Department of Medicine B, Gastroenterology and Hepatology, University Hospital 
      Muenster, Muenster, Germany.
FAU - Ellermann, C
AU  - Ellermann C
AUID- ORCID: 0000-0002-9172-296X
AD  - Department of Cardiology II (Electrophysiology), University Hospital Muenster, 
      Albert-Schweitzer Campus 1, 48149, Munster, Germany. 
      christian.ellermann@ukmuenster.de.
FAU - Dechering, D G
AU  - Dechering DG
AD  - Department of Cardiology II (Electrophysiology), University Hospital Muenster, 
      Albert-Schweitzer Campus 1, 48149, Munster, Germany.
FAU - Frommeyer, G
AU  - Frommeyer G
AD  - Department of Cardiology II (Electrophysiology), University Hospital Muenster, 
      Albert-Schweitzer Campus 1, 48149, Munster, Germany.
FAU - Kochhauser, S
AU  - Kochhauser S
AD  - Department of Cardiology II (Electrophysiology), University Hospital Muenster, 
      Albert-Schweitzer Campus 1, 48149, Munster, Germany.
FAU - Lange, P S
AU  - Lange PS
AD  - Department of Cardiology II (Electrophysiology), University Hospital Muenster, 
      Albert-Schweitzer Campus 1, 48149, Munster, Germany.
FAU - Pott, C
AU  - Pott C
AD  - Department of Cardiology, Schuechtermann-Klinik, Bad Rothenfelde, Germany.
FAU - Lenze, F
AU  - Lenze F
AD  - Department of Medicine B, Gastroenterology and Hepatology, University Hospital 
      Muenster, Muenster, Germany.
FAU - Kabar, I
AU  - Kabar I
AD  - Department of Medicine B, Gastroenterology and Hepatology, University Hospital 
      Muenster, Muenster, Germany.
FAU - Schmidt, H
AU  - Schmidt H
AD  - Department of Medicine B, Gastroenterology and Hepatology, University Hospital 
      Muenster, Muenster, Germany.
FAU - Ullerich, H
AU  - Ullerich H
AD  - Department of Medicine B, Gastroenterology and Hepatology, University Hospital 
      Muenster, Muenster, Germany.
FAU - Eckardt, L
AU  - Eckardt L
AD  - Department of Cardiology II (Electrophysiology), University Hospital Muenster, 
      Albert-Schweitzer Campus 1, 48149, Munster, Germany.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210225
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Aged
MH  - Atrial Fibrillation/surgery
MH  - Cryosurgery/adverse effects/*methods
MH  - Female
MH  - Gastroesophageal Reflux/complications
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Pulmonary Veins/*surgery
MH  - Treatment Outcome
PMC - PMC7907235
COIS- The authors declare no competing interests.
EDAT- 2021/02/27 06:00
MHDA- 2021/12/15 06:00
PMCR- 2021/02/25
CRDT- 2021/02/26 05:57
PHST- 2020/07/24 00:00 [received]
PHST- 2021/02/08 00:00 [accepted]
PHST- 2021/02/26 05:57 [entrez]
PHST- 2021/02/27 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/02/25 00:00 [pmc-release]
AID - 10.1038/s41598-021-83928-0 [pii]
AID - 83928 [pii]
AID - 10.1038/s41598-021-83928-0 [doi]
PST - epublish
SO  - Sci Rep. 2021 Feb 25;11(1):4728. doi: 10.1038/s41598-021-83928-0.