Esophageal Thermal Injury after Catheter Ablation for Atrial Fibrillation with High-Power (50 Watts) Radiofrequency Energy

BACKGROUND AND OBJECTIVES: Data regarding the safety of atrial fibrillation (AF) ablation using high-power (50 W) radiofrequency (RF) energy in Asian populations are limited. This study was conducted to evaluate the incidence and pattern of esophageal injury after high-power AF ablation in an Asian...

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Detalles Bibliográficos
Autores principales: Do, Ungjeong, Kim, Jun, Kim, Minsoo, Cho, Min Soo, Nam, Gi-Byoung, Choi, Kee-Joon, Kim, You-Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Cardiology 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7853895/
https://www.ncbi.nlm.nih.gov/pubmed/33525069
http://dx.doi.org/10.4070/kcj.2020.0323
Descripción
Sumario:BACKGROUND AND OBJECTIVES: Data regarding the safety of atrial fibrillation (AF) ablation using high-power (50 W) radiofrequency (RF) energy in Asian populations are limited. This study was conducted to evaluate the incidence and pattern of esophageal injury after high-power AF ablation in an Asian cohort. METHODS: We searched the prospective AF ablation registry to identify patients who underwent AF ablation with 50 W RF energy using the smart touch surround flow catheter (Biosense Webster, Diamond Bar, CA, USA). Visitag™ (Biosense Webster) was used for lesion annotation with predefined settings of catheter stability (3 mm for 5 seconds) and minimum contact force (50% of time >5 g). All patients underwent upper gastrointestinal endoscopy at 1 or 3 days after the ablation. RESULTS: A total of 159 patients (mean age: 63±9 years, male: 69%, paroxysmal AF: 45.3%, persistent AF: 27.7%, long-standing persistent AF: 27.0%) were analyzed. Initially, 26 patients underwent pulmonary vein isolation with 50 W for 5 seconds at each point. The remaining 133 patients underwent prolonged RF duration (anterior 10 seconds and posterior 6 seconds). The incidence rates of esophageal erythema/erosion and superficial ulceration were 1.3% for each type of the lesion. Food stasis, a suggestive finding of gastroparesis, was observed in 25 (15.7%) patients. There were no cases of cardiac tamponade, stroke, or death. CONCLUSIONS: In Asian patients, AF ablations using 50 W resulted in very low rates of mild esophageal complications.