Temperature monitoring and temperature-driven irrigated radiofrequency energy titration do not prevent thermally induced esophageal lesions in pulmonary vein isolation: A randomized study controlled by esophagoscopy before and after catheter ablation

Meininghaus, Dirk Große; Blembel, Kai; Waniek, Claudia; Kruells-Muench, Juergen; Ernst, H.; Kleemann, Tobias; Geller, J. Christoph

doi:10.1016/j.hrthm.2021.02.003

Cited by 43 publications

(76 citation statements)

References 18 publications

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“…The newer published studies regrading monitoring LET during atrial fibrillation ablation, which were reported by Dr. Clark and Dr. Kulstad, have been published during our manuscript publication process. Nevertheless, these studies that reported by Dr. Clark and Dr. Kulstad showed same conclusion of inadequate LET monitoring in preventing esophageal injury [1][2][3] .…”

Section: Disclosure: Mahmoud Houmsse Has No Conflict Of Interestsupporting

confidence: 58%

Reply to “Additional Data on Protection of the Esophagus during Catheter Ablation of Atrial Fibrillation”

Houmsse

Daoud

2021

Preprint

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Section: Disclosure: Mahmoud Houmsse Has No Conflict Of Interestsupporting

confidence: 58%

Reply to “Additional Data on Protection of the Esophagus during Catheter Ablation of Atrial Fibrillation”

Houmsse

Daoud

2021

Preprint

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“…The evidence for esophageal temperature monitoring probes is summarised in Table 1. 35,36,[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53] In the observational studies alone, we find that in 1558 patients who had AF ablation (243 cryoablations; 1315 radiofrequency, including high power short duration) with a type of commercially available esophageal temperature monitoring probe; 209 had an esophageal mucosal lesion. The studies occurred over a timeperiod of 2009-2020.…”

Section: Temperature Monitoring Probesmentioning

confidence: 99%

Preventing esophageal complications from atrial fibrillation ablation: A review

et al. 2021

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“…3 Most recently, an RCT by Grosse Meininghaus et al found a 14% injury rate using multi-sensor LET monitoring versus a 5% rate with no LET monitoring (although the most severe lesion, a deep ulcer, was found in the unmonitored group). 4 Current recommendations only provide a Class IIa recommendation for LET monitoring, with the level of evidence C-EO (expert opinion), and have not incorporate the latest data from these three studies demonstrating the lack of benefit, and potential harm, from LET monitoring. 5 Kar et al found a lag time between the peak epiesophageal and endoluminal temperatures of 13.0 ± 11.0 s in standard ablation, and 24.2 ± 22.1 s in high-power short-duration (HPSD) ablation, with a gradient between the peak epiesophageal surface temperature and the concurrent endoluminal temperature of 1.7 ± 2.0°C in standard ablation and 5.1 ± 5.3°C in HPSD ablation.…”

mentioning

confidence: 99%