Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Ablation Techniques D-PO01 - Featured Poster Session (ID 11) Poster

D-PO01-164 - Endoscopic Evaluation Of The Esophagus After Catheter Ablation For Atrial Fibrillation With High-power (50 W) Radiofrequency Energy (ID 122)

 U. Do: Nothing relevant to disclose.


Background: There is a safety concern regarding atrial fibrillation <AF> ablation using high-power <50 Watts> radiofrequency <RF> energy.
Objective: We evaluated the incidence and pattern of esophageal injury after high-power AF ablation in our study cohort.
Methods: From the prospective AF ablation registry, 160 patients who underwent ablation with 50 W RF energy were analyzed <age 63 ± 9 years, 68% male, 45.6% with paroxysmal AF, 27.5% with persistent AF and 26.9% with long-standing persistent AF>. Initially, 26 patients underwent pulmonary vein <PV> isolation with 50 W for 5 s. We prolonged the RF time to 10 s at the anterior and superior PV antrum and to 6 s at the posterior PV antrum in the remaining 134 patients. Visitag <Biosense Webster> was used for lesion annotation with predefined settings of catheter stability <3 mm for 5 s> and minimum CF <50% of time >5 g>.
Results: The mean CHA2DS2‐VASc score was 1.9 ± 1.4 and left atrial anteroposterior dimension was 44 ± 7mm. PV isolation was achieved in all patients. The incidence of esophageal erythema/erosion was 2 of 160 <1.3%> and of superficial ulceration was 1 of 160 <0.6%>. Food stasis, a likely suggestive finding of gastroparesis, was observed in 25 patients <15.6%>. However, no patient required medical treatment for gastroparesis. Cardiac tamponade, stroke, or death did not occur in any patient. Arrhythmic recurrence over the blanking period occurred in 29 of 104 patients during the median follow up duration of 186 days <interquartile range: 108-210>.
Conclusion: AF ablations using 50 W showed very low rates and mild pattern of esophageal complication.