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KMID : 0368120210510020143
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Korean Circulation Journal
2021 Volume.51 No. 2 p.143 ~ p.153
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Esophageal Thermal Injury after Catheter Ablation for Atrial Fibrillation with High-Power (50 Watts) Radiofrequency Energy
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Do Ung-Jeong
Kim Jun
Kim Min-Soo
Cho Min-Soo
Nam Gi-Byoung
Choi Kee-Joon
Kim You-Ho
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Abstract
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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.
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KEYWORD
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Atrial fibrillation, Complications, Endoscopy, Esophagus, Radiofrequency catheter ablation
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