An Esophageal Cooling Device During Radiofrequency Ablation for Atrial Fibrillation—A Comparison Between Reactive and Proactive Esophageal Cooling

• DOI: 10.19102/icrm.2022.13111
• Publication Date: 2024-05-03T17:31:27Z
• Authors: BRAD CLARK; NAZIA ALVI; JOSEPH HANKS; CHRISTOPHER JOSEPH; BRAD SUPRENANT
• Keywords: Esophagogastroduodenoscopy

Esophageal thermal injury is one of the most feared risks ablation posterior left atrium despite various devices used to monitor esophageal temperature or deviate esophagus. Reactive cooling, in which cold water manually instilled into esophagus via an orogastric tube response rises luminal (LET), has been by operators, but availability a dedicated cooling device offers ability provide proactive without having react individual The objective this study was evaluate feasibility using commercially available protection during atrial catheter ablation, then compare approach standard LET monitoring with reactive manual cold-water instillation. In study, we randomized 6 patients undergoing for fibrillation. Three received care our site (use single-sensor probe, adjunct ice-water instillation any increases >1°C). underwent after placement at circulating 4°C, use monitoring. All transesophageal echocardiography and esophagogastroduodenoscopy on day prior followed second after. were enrolled between March August 2018. 3 control patients, 1 had no evidence mucosal damage, diffuse sloughing mucosa multiple ulcerations, superficial ulcer large clot. Both lesions classified as 2a cases Zargar grading scheme caustic injury. treated device, erythema (Zargar grade 1), solitary lesion. At months follow-up, patient each group recurrence Although number subsequent studies have confirmed reduction only date (via instillation) device). Moreover, first support purpose provides basis further investigation.