Mechanism of Injury
The exact mechanism of ablation injury to the esophagus is unclear and
may be multifactorial. A common explanation is the direct effect of
ablation energy resulting in injury to the esophagus – either with RF
or cryo-ablation energy. Another potential mechanism is focal ischemia
overlapping the site of ablation. Esophageal blood supply consists of
arborizing arterial system over the surface of the esophagus. Ablation
energy can result in ischemia due to occlusion of arteriole supply.
Also, ablation energy can impact the vagal plexi over the esophagus
resulting in gastroparesis with subsequent acid reflux.