Incidence of esophageal injury after pulmonary vein isolation in patients with a low body mass index and esophageal temperature monitoring at a 39 °C setting

Abstract

Catheter ablation using ETM reduced the incidence of esophageal injuries, even in patients with a low BMI.

The influence of ablation power reduction associated with oesophagus location on pulmonary vein isolation results in patients with paroxysmal atrial fibrillation: six-month follow-up

“…In the cohort, the majority of patients had the central course of oesophagus in relation to LA. These findings are in line with relations observed in the previous studies of Bunch et al [20] and Kottkamp et al [21] but are in contrast to the studies of Kiuchi et al [12] with the majority of patients with left-sided oesophageal courses in relation to the LA posterior wall [17]. Unexpectedly, despite initial power reduction and mostly central oesophageal location, we noticed a significant temperature increase to > 39°C in 80% of patients.…”

“…Unexpectedly, despite initial power reduction and mostly central oesophageal location, we noticed a significant temperature increase to > 39°C in 80% of patients. This finding is comparable with previously published data [17] and emphasises the relevance of caution in LA posterior ablation with support of oesophageal temperature monitoring in all patients. The explanation for this further temperature increase could be based on the observation that the oesophageal temperature gradually increases by 1-3°C within 10-20 s even after cessation of RF energy application [14].…”

“…The presence of temperature increase in all patients with right-sided oesophageal location could be associated with the wall thinness in this area. In particular, the lower parts of the LA are at increased risk because it was shown that the distances between oesophagus and LA posterior wall are shorter behind the inferior than the superior parts of the LA, where the posterior LA is mostly in contact with the oesophagus [17,21].…”

“…To avoid these complications, real-time intraluminal oesophageal temperature monitoring during ablation with the oesophageal temperature probes advanced to the level of the LA could be used. Additionally, the probe could be a marker of the oesophageal lumen location in relation to PV ostia [3,12,[14][15][16][17]. It was reported that the use of temperature monitoring significantly reduces the oesophageal injury ratio (6% vs. 36%, p < 0.006) without any serious complications related to the probe [3,12].…”

Esophageal Temperature Monitoring During Radiofrequency Ablation of Atrial Fibrillation: A Meta-Analysis

“…Our search resulted in the identification of 4 non-randomized controlled trials that met our search criteria (Table 1). 10,[19][20][21] In the first study published in 2008, Singh et al 21 retrospectively analyzed 81 consecutive patients who had undergone AF ablation followed by EGD and compared the LET vs no LET groups. They noted a significantly higher frequency of esophageal injury in patients who had not undergone LET monitoring during ablation.…”