高功率短时间消融（HPSD）是治疗心房颤动的有效方法，但食管热损伤是一个罕见但相关的副作用。在这项回顾性单中心分析中，我们评估了消融引起的检查结果发现的发生率和相关性，以及偶然发现的胃肠道疾病的患病率。在15个月的时间里，我们通过术后食管胃十二指肠镜检查筛查了所有接受消融治疗的患者。对病理学发现进行了跟踪和必要的治疗。此次研究共包括286位连续患者（66±10岁；54.9% 男性），其中19.6% 的患者出现了与消融相关的变化（10.8% 食管病变，10.8% 胃排空障碍，1.7% 两种发现同时存在）。逻辑回归多变量分析证实了低 BMI 对 RFA 相关内镜发现的影响（OR=0.936，95% CI 0.878-0.997，p<0.05）。48.3% 的患者出现了意外的胃肠道发现，其中1.0% 是肿瘤病变，9.4% 显示出恶性前病变，4.2% 发现了未知怀疑恶性病变，需要进一步诊断或治疗。18.1% 的患者出现了与抗凝治疗下潜在出血风险升高相关的发现。具有临床意义的偶然发现的患者中男性比例显著更高，为68.8%，而非该群体的49.5%（p<0.01）。HPSD 消融治疗是安全的，任何患者都没有出现过灾难性的并发症。其中19.6% 的患者出现了消融相关的热损伤，而48.3% 的患者出现了胃肠道上部意外发现。由于发现需要进一步诊断、治疗或监测的患病率高达14.7%，并且这是模拟一般人群的人群，因此对一般人群进行上部胃肠道筛查似乎是有道理的。版权所有 ©2023 Elsevier B.V.发布。

High-power short-duration ablation (HPSD) is an effective therapy for atrial fibrillation with thermal esophageal injury as a rare but relevant side effect.In this retrospective single-center analysis we evaluated the incidence and relevance of ablation-induced findings and the prevalence of ablation-independent incidental gastrointestinal findings. For 15 months all patients undergoing ablation were screened by postablation esophagogastroduodenoscopy. Pathological findings were followed up and treated if necessary.286 consecutive patients (66±10 years; 54.9% male) were included. 19.6% of patients showed ablation-associated alterations (10.8% esophageal lesions, 10.8% gastroparesis, 1.7% both findings). Logistic multivariable regression analysis confirmed an influence of lower BMI on the occurrence of RFA-associated endoscopic findings (OR 0.936, 95% CI 0.878-0.997, p<0.05). 48.3% of patients demonstrated incidental gastrointestinal findings. In 1.0% neoplastic lesions were present, 9.4% showed precancerous lesions and in 4.2% neoplastic lesions of unknown dignity were found requiring further diagnostics or therapy. 18.1% of patients demonstrated findings associated with a potentially increased risk of bleeding under anticoagulation. Patients with clinically relevant incidental findings were significantly more often male, 68.8% vs. 49.5% (p<0.01).HPSD ablation is safe, no devasting complication occurred in any patient. It resulted in 19.6% ablation-induced thermal injury whereas incidental findings of the upper GI tract were found in 48.3% of patients. Due to the high prevalence of 14.7% of findings requiring further diagnostics, therapy, or surveillance in a cohort that is mimicking the general population, screening endoscopy of the upper GI tract seems to be reasonable in the general population.Copyright © 2023. Published by Elsevier B.V.