Do Ungjeong, Kim Jun, Kim Minsoo, Cho Min Soo, Nam Gi Byoung, Choi Kee Joon, Kim You Ho
Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Korean Circ J. 2021 Feb;51(2):143-153. doi: 10.4070/kcj.2020.0323.
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.
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.
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.
In Asian patients, AF ablations using 50 W resulted in very low rates of mild esophageal complications.
关于在亚洲人群中使用高功率（50瓦）射频（RF）能量进行心房颤动（AF）消融安全性的数据有限。本研究旨在评估亚洲队列中高功率AF消融术后食管损伤的发生率和模式。
我们检索了前瞻性AF消融登记册，以识别使用智能触摸环绕流导管（美国加利福尼亚州钻石吧市百盛韦伯斯特公司）以50瓦RF能量进行AF消融的患者。使用Visitag™（百盛韦伯斯特公司）按照预设的导管稳定性（3毫米持续5秒）和最小接触力（50%的时间>5克）进行病变标注。所有患者在消融后1天或3天接受上消化道内镜检查。
共分析了159例患者（平均年龄：63±9岁，男性：69%，阵发性AF：45.3%，持续性AF：27.7%，长期持续性AF：27.0%）。最初，26例患者在每个点以50瓦进行5秒的肺静脉隔离。其余133例患者进行了延长的RF持续时间（前部10秒和后部6秒）。每种类型病变的食管红斑/糜烂和浅表溃疡的发生率均为1.3%。25例（15.7%）患者观察到食物淤滞，这是胃轻瘫的一个提示性表现。没有心脏压塞、中风或死亡病例。
在亚洲患者中，使用50瓦进行AF消融导致轻度食管并发症的发生率非常低。
