Factors associated with periesophageal vagal nerve injury after pulmonary vein antrum isolation.

General anesthesia itself showed a significant trend of increasing the risk of direct esophageal injury. 20 – 21 A strong relationship between an esophageal temperature rise and pain has been shown by prior study. 22 Use of a proton pump inhibitor might facilitate ulcer healing and prevent the progression from esophageal injury to an atrioesophageal fistula. 23 – 24 In contrast, PNI was observed in 7.9% of the patients during the period when 25 to 30 W were applied to the posterior LA, suggesting that the periesophageal vagal nervous system was much more fragile than the esophagus itself to thermal injury.

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