Mechanical displacement of the esophagus in patients undergoing left atrial ablation of atrial fibrillation.

Background: Left atrial (LA) ablation of atrial fibrillation (AF) may rarely be complicated by an atrio-esophageal fistula.

Objective: The purpose of this study was to determine the feasibility of mechanical displacement of the esophagus in patients undergoing LA ablation.

Methods: Twelve patients underwent mechanical displacement of the esophagus performed by an endoscopist during an LA ablation procedure under conscious sedation.

Atypical presentations of gastroesophageal reflux disease.

Gastroesophageal reflux disease typically manifests as heartburn and regurgitation, but it may also present with atypical or extraesophageal symptoms, including asthma, chronic cough, laryngitis, hoarseness, chronic sore throat, dental erosions, and noncardiac chest pain. Diagnosing atypical manifestations of gastroesophageal reflux disease is often a challenge because heartburn and regurgitation may be absent, making it difficult to prove a cause-and-effect relationship. Upper endoscopy and 24-hour pH monitoring are insensitive and not useful for many patients as initial diagnostic modalities for evaluation of atypical symptoms.