ArticleBiomedical engineering online2020
Modeling esophageal protection from radiofrequency ablation via a cooling device: an analysis of the effects of ablation power and heart wall dimensions.
Article in Biomedical engineering online, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 20 citations in OpenAlex.
- Effect of esophageal cooling on ablation lesion formation in the left atrium: Insights from Ablation Index data in the IMPACT trial and clinical outcomes.Journal of cardiovascular electrophysiology · 2022Trial
- Participant-reported chest pain and gastric esophageal reflux disease following protective esophageal cooling during radiofrequency ablation for atrial fibrillation - the EVERCOOL-AF study.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Pulsed Field Ablation Therapy Parameters: Enhancing Lesion Depth While Reducing Musculoskeletal Stimulation and Thermal Response in an Irrigated Tip Catheter: A Comprehensive Study Using In Silico, In Vitro, and In Vivo Models.Circulation. Arrhythmia and electrophysiology · 2026Article
- Mechanisms of action behind the protective effects of proactive esophageal cooling during radiofrequency catheter ablation in the left atrium.Heart rhythm O2 · 2024Review
- Improved 1-year outcomes after active cooling during left atrial radiofrequency ablation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2023Article
- Active esophageal cooling during radiofrequency ablation of the left atrium: data review and update.Expert review of medical devices · 2022Review
- Procedural time reduction associated with active esophageal cooling during pulmonary vein isolation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2022Article
- Proactive esophageal cooling protects against thermal insults during high-power short-duration radiofrequency cardiac ablation.International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group · 2022Article
- Preventing esophageal complications from atrial fibrillation ablation: A review.Heart rhythm O2 · 2021Article
- Impact of Active Esophageal Cooling on Fluoroscopy Usage During Left Atrial Ablation.The Journal of innovations in cardiac rhythm management · 2021Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEsophageal thermal injury can occur after radiofrequency (RF) ablation in the left atrium to treat atrial fibrillation. Existing methods to prevent esophageal injury have various limitations in deployment and uncertainty in efficacy. A new esophageal heat transfer device currently available for whole-body cooling or warming may offer an additional option to prevent esophageal injury. We sought to develop a mathematical model of this process to guide further studies and clinical investigations and compare results to real-world clinical data.
resultsThe model predicts that the esophageal cooling device, even with body-temperature water flow (37 °C) provides a reduction in esophageal thermal injury compared to the case of the non-protected esophagus, with a non-linear direct relationship between lesion depth and the cooling water temperature. Ablation power and cooling water temperature have a significant influence on the peak temperature and the esophageal lesion depth, but even at high RF power up to 50 W, over durations up to 20 s, the cooling device can reduce thermal impact on the esophagus. The model concurs with recent clinical data showing an 83% reduction in transmural thermal injury when using typical operating parameters.
conclusionsAn esophageal cooling device appears effective for esophageal protection during atrial fibrillation, with model output supporting clinical data. Analysis of the impact of ablation power and heart wall dimensions suggests that cooling water temperature can be adjusted for specific ablation parameters to assure the desired myocardial tissue ablation while keeping the esophagus protected.
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