OBJECTIVES: To evaluate throat pain and discomfort caused by transesophageal echocardiography (TEE), which is required to screen cardiac thrombus before radio-frequency ablation (RA) for atrial fibrillation (AF).

METHODS: This survey study enrolled hospitalized patients who underwent TEE before their scheduled RA for AF in a Chinese tertiary care hospital from March 1, 2022, to May18, 2022. The survey questionnaire collected patient characteristics, TEE examination information, self-reported throat pain and discomfort before and after TEE examination, and patient’s willingness for new technology to replace TEE. The collected information was summarized using descriptive statistical methods. The distributions of throat pain and discomfort before and after TEE examination were compared using McNemar test.

RESULTS: 121 eligible patients were successfully surveyed [mean age: 61.1 years; male: 60.3%, AF type: paroxysmal AF (81.8%) and persistent AF (18.2%), main comorbidity: hypertension (46.3%) and diabetes (14.0%)]. TEE was conducted under local anaesthetization. 5.8% of the included patients required additional treatments in blood pressure and/or rhythm control before the examination. The surveyed patients reported that the throat pain rate after the TEE examination was significantly and substantially higher than that before the examination (62.8% vs. 1.7%, p<0.001). Among the patients reporting pain after the examination, 61.8% reported moderate-to-severe throat pain. The surveyed patients also reported significantly higher rate of any types of throat discomfort (75.2% vs. 14.9%, p<0.001) after TEE examination. The main reported throat discomfort after the examination included foreign body sensation (47.1%), retching (30.6%), nausea (28.9%), difficulty speaking (22.3%), and bleeding (20.7%). 84.3% of the patients were willing to replace TEE with a new technology for cardiac thrombus screening.

CONCLUSIONS: Throat pain and discomfort associated with TEE are common in Chinese patients with planned RA for AF. Most patients are still looking forward to a new technology that can avoid the unpleasant examination experience and inconvenience with TEE.