AB-453068-3 ESOPHAGEAL TEMPERATURE AND ESOPHAGEAL DAMAGE IN HIGH POWER SHORT DURATION ABLATION SETTINGS

Radiofrequency ablation (RFA) of atrial fibrillation (AF) using high-power short-duration (HPSD) settings (50W, 10s or up to 90W, 4s) are increasingly common, seeking maximize resistive rather than conductive heating limit the risk esophageal damage. The real-time luminal temperature (LET) response and damage HPSD not fully established. To investigate LET RFA on posterior LA wall. We ablated deep inferior pulmonary vein (IPV) in close proximity esophagus 14 pigs, either Termocool SmartTouch Catheter (HPSD 50W/10s, n=7), QDOT 90W/4s, n=7). was monitored with a 12-sensor CIRCA probe. delivered IPV apposition as verified 3D maps. collected LET, parameters; endoscopy, macro- microscopic examination esophagus. In 3 pigs each group, survival prolonged 1 month for chronic characterization lesions. Total energy (90W/4s vs. 50W/10s) higher group (60.8±18.8W 48.9±0.1W, p<0.005), peak at catheter tip (51.2±3.1°C 25.3±2.8°C, p<0.005). Peak lower 90W/4s 50W/10s (38.7±1.5°C 40.5±3.1°C, Temperatures >40°C were reached 14/90 ablations vs 43/94 (p<0.001). Acute lesions found all pigs. acute involved affecting outer muscularis layer 4/4 submucosa 1/4. However, no identified 3/3. group: entire into submucosa, reaching mucosa 2. Chronic only pig – complete replacement scar (with submucosal inflammation). All occurred after high LETs. (Figure) can create significant leads LETs, lead but be used monitor both protocols.