Background: Gastroesophageal reflux (GER) in radiofrequency catheter ablation (RFCA) occurs due to vagal plexus damage during pulmonary vein isolation. A supraglottic device (SGD) is used instead of a tracheal intubation to minimize the sympathetic response.
Objective: Since the safety of SGDs used in RFCA has not yet been verified, we compared the pH before and after the RFCA of atrial fibrillation (AF) at three areas (mid-oesophagus, low-oesophagus and oropharynx).
Methods: We studied 30 patients who were scheduled for RFCA of AF under general anesthesia. Anesthesia was performed using an SGD with a suction port. Two oesophageal temperature probes capable of suction and measuring temperature were inserted through the suction port. The pH of the three areas was measured before and after the RFCA.
Results: GER was observed in 13 of 30 patients (43%). In one patient, it was observed in the oropharynx, in four patients it was observed in the mid-oesophagus, and in 13 patients, it was observed in the low-oesophagus. For patients with GER at the oropharynx and mid-oesophagus, it was also observed at the low-oesophagus. The difference in the pH before and after the RFCA was not significant at the oropharynx and mid-oesophagus (P=0.726 and P=0.424, respectively), but it was significantly different at the low-oesophagus (P<0.001). The total ablation time was longer in the GER group compared to the non-GER group (P=0.021).
Conclusion: GER after RFCA occurred in 43% of patients, but critical complications did not occur with the use of SGDs. The use of SGDs in AF ablation can be relatively safe, but care should be taken, as it does not completely eliminate the possibility of aspiration.