Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO02 - Poster Session II (ID 47) Poster

D-PO02-138 - The Esophagus And Atrial Fibrillation Ablation With High Power Short Duration Energy (ID 1027)

Disclosure
 K. Ayinapudi: Nothing relevant to disclose.

Abstract

Background: Esophageal injury continues to be a challenge during the ablation of atrial fibrillation (AF) procedure.
Objective: We sought to study the efficacy of the multisensor esophageal temperature monitoring system in predicting true positive esophageal lesions during ablation.
Methods: All patients underwent ablation of AF applying the pulmonary vein (PV) isolation strategy in addition to fibrosis/low voltage zone/non-PV triggers if needed. High power short duration (HPSD) ablation lesions were delivered in all patients. All patients had a 12-sensor temperature probe inserted prior to ablation. During ablation, operator was blinded to the probe measurement. Afterwards, every patient with more than 2 degrees temperature increase at any of the 12 sensors were taken to the endoscopy suite for assessment of esophageal injury.
Results: In ten patients while ablating the posterior wall of the left atrium, we recorded a mean change of 4.2 °C with a maximum value of 5.5 °C temperature rise as shown in table 1. After every one of these procedure, 3D electro anatomical mapping showed extensive lesions delivered on the posterior wall of the left atrium. Negative endoscopy was reported in all patients, with no macroscopic/superficial lesions on the EGD after HPSD RF ablation. There were no immediate post procedural complications.
Conclusion: Despite higher intraluminal esophageal temperature, HPSD seems to provide effective lesions that are confined in the posterior wall, sparing deeper tissues. Although temperature monitoring remains important, the short duration of the ablation lesion helps prevent esophageal injury when using the HPSD approach.
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