Abstract: |
Atrial fibrillation (AF) that is refractory to medication therapy is often managed with catheter ablation. Complications of catheter ablation include esophageal damage (erosion, ulceration, or perforation) leading to atrioesophageal fistula (AEF), which can be life-threatening. Although the mechanisms of AEF are not fully understood, it has been postulated that acid reflux contributes to the progression. Therefore, treatment with gastrointestinal (GI) protective therapy, including proton pump inhibitors, histamine-2 receptor antagonists, and sucralfate for up to 4 weeks, has demonstrated some efficacy. The 2012 Catheter and Surgical Ablation of Atrial Fibrillation guidelines recommend this for all patients post AF ablation. Pharmacists should be aware of the unique role of GI protective therapy in this special population and be diligent in ensuring proper use of these agents through education. © 2014, Jobson Publishing Corporation. All rights reserved. |