Acute oesophageal safety of high-power short duration with 50 W for atrial fibrillation ablation

• Verfasst von: Müller, Julian [VerfasserIn]
• Verfasst von: Berkovitz, Artur [VerfasserIn]
• Verfasst von: Halbfass, Philipp [VerfasserIn]
• Verfasst von: Nentwich, Karin [VerfasserIn]
• Verfasst von: Ene, Elena [VerfasserIn]
• Verfasst von: Sonne, Kai [VerfasserIn]
• Verfasst von: Simu, Gelu [VerfasserIn]
• Verfasst von: Chakarov, Ivalyo [VerfasserIn]
• Verfasst von: Barth, Sebastian [VerfasserIn]
• Verfasst von: Waechter, Christian [VerfasserIn]
• Verfasst von: Behnes, Michael [VerfasserIn]
• Verfasst von: Akın, Ibrahim [VerfasserIn]
• Verfasst von: Deneke, Thomas [VerfasserIn]
• Titel: Acute oesophageal safety of high-power short duration with 50 W for atrial fibrillation ablation
• Verf.angabe: Julian Müller, Artur Berkovitz, Philipp Halbfass, Karin Nentwich, Elena Ene, Kai Sonne, Gelu Simu, Ivalyo Chakarov, Sebastian Barth, Christian Waechter, Michael Behnes, Ibrahim Akin, and Thomas Deneke
• E-Jahr: 2022
• Jahr: 02 February 2022
• Umfang: 10 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 12.12.2023
• Titel Quelle: Enthalten in: Europace
• Ort Quelle: Oxford : Oxford Univ. Press, 1999
• Jahr Quelle: 2022
• Band/Heft Quelle: 24(2022), 6 vom: Juni, Seite 928-937
• ISSN Quelle: 1532-2092
• DOI: doi:10.1093/europace/euab329
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1873107986

Abstract

Pulmonary vein isolation (PVI) using radiofrequency (RF) ablation is an effective treatment option for patients with atrial fibrillation (AF). This study aims to investigate the safety of high-power short duration (HPSD) with emphasis on oesophageal lesions after PVI.Consecutive patients undergoing AF ablation with HPSD (50 W; ablation index (AI)-guided; target AI 350 for posterior wall ablation, AI 450 for anterior wall ablation) using the ThermoCool SmartTouch SF catheter were included. Patients underwent post-ablation oesophageal endoscopy to detect and categorize thermal oesophageal injury (EDEL). Occurrence and risk factors of oesophageal lesions and perforating complications were analysed. A total of 1033 patients underwent AF ablation with HPSD. Of them, 953 patients (67.6 ± 9.6 years; 58% male; 43% paroxysmal AF; 68% first PVI) underwent post-procedural oesophageal endoscopy and were included in further analyses. Median procedure time was 82.8 ± 24.4 min with ablation times of 16.1 ± 9.2 min. Thermal oesophageal injury was detected in 58 patients (6%) (n = 29 Category 1 erosion, n = 29 Category 2 ulcerous). One patient developed oesophageal perforation (redo, 4th AF ablation). No patient died. Using multivariable regression models, increased total ablation time [odds ratio (OR) 1.029, P = 0.010] and history of stroke (OR 2.619, P = 0.033) were associated with increased incidence of EDEL after AF ablation, whereas increased body mass index was protective (OR 0.980, P = 0.022).Thermal oesophageal lesions occur in 6% of HPSD AF ablations. The risk for development of perforating complications seems to be low. Incidence of atrio-oesophageal fistula (0.1%) is comparable to other reported series about RF ablation approaches.