Abstract 14986: Reduced Arrhythmia Recurrence at One-Year When Using Active Esophageal Cooling

Abstract

Introduction: The use of active esophageal cooling instead of traditional luminal esophageal temperature (LET) monitoring during left atrial ablation for the treatment of atrial fibrillation (AF) allows contiguous lesion placement with fewer partially-formed lesions and less catheter repositioning than required with LET monitoring. As a consequence, fewer electrical reconnections, and a lower rate of atrial arrhythmia recurrence, may result. We aimed to determine the association between esophageal protective strategy and recurrence of arrhythmia at one-year. Methods: We performed an IRB-approved review of an existing hospital registry to measure the association between recurrence of arrhythmia at one year follow-up and the use of active esophageal cooling as opposed to LET monitoring. Data were collected from ablations performed between 2017 and 2020. For each patient we recorded the type of esophageal temperature management, rhythm status at one-year follow-up, ejection fraction, and CHA 2 DS 2 -VASc score. Results: Data from a total of 247 ablations were collected. There were 95 ablations that occurred in the actively cooled group and 152 in the LET monitored group. Among those in the actively cooled group, the average CHA 2 DS 2 -VASc score was 1.8, and the average ejection fraction was 61%. In the LET monitored group, the average CHA 2 DS 2 -VASc score was 1.2 and the average ejection fraction was 61%. In the LET monitored group, there were 36 patients who had atrial arrhythmias at one-year follow-up, representing a 24% recurrence rate. In the actively cooled group, 11 patients had recurrence of arrhythmia at one-year, representing a 12% recurrence rate (P=0.02). Conclusions: Patients treated with active esophageal cooling during left atrial ablation had a significantly lower atrial arrhythmia recurrence rate at one-year follow-up when compared to patients provided with traditional LET monitoring during left atrial ablation procedures.