Trial reportJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2022
Active esophageal cooling for the prevention of thermal injury during atrial fibrillation ablation: a randomized controlled pilot study.
Trial report in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pentaspline Pulsed Field Ablation Versus High-Power Short-Duration/Very High-Power Short-Duration Radiofrequency Ablation in Atrial Fibrillation: A Meta-Analysis.Journal of cardiovascular electrophysiology · 2025Pooled it
- Role of oesophageal cooling in the prevention of oesophageal injury in atrial fibrillation catheter ablation: a systematic review and meta-analysis of randomized controlled trials.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Pooled it
- Esophageal temperature management during cryoballoon ablation for atrial fibrillation.Journal of cardiovascular electrophysiology · 2022Trial
- 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
- [Catheter ablation-induced esophageal complications].Herzschrittmachertherapie & Elektrophysiologie · 2026Review
- Concise Guidelines of the European Cardiac Arrhythmias Society (ECAS) on "Catheter Ablation of Atrial Fibrillation".Journal of cardiovascular electrophysiology · 2025Article
- Proactive esophageal cooling during radiofrequency cardiac ablation: data update including applications in very high-power short duration ablation.Expert review of medical devices · 2025Review
- Hybrid convergent procedure with proactive oesophageal cooling for the treatment of long-standing persistent atrial fibrillation: a case series.European heart journal. Case reports · 2024Article
- Posterior wall ablation for persistent atrial fibrillation: Very-high-power short-duration versus standard-power radiofrequency ablation.Heart rhythm O2 · 2024Article
- 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
- Fluoroless catheter ablation of atrial fibrillation: a step-by-step workflow.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2023Review
- Letter to the editor: oesophageal cooling for protection during left atrial ablations.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Role of oesophageal cooling in the prevention of oesophageal injury in atrial fibrillation catheter ablation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 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
- An Esophageal Cooling Device During Radiofrequency Ablation for Atrial Fibrillation-A Comparison Between Reactive and Proactive Esophageal Cooling.The Journal of innovations in cardiac rhythm management · 2022Article
- Atrioesophageal fistula-A focus on preventing a devastating complication.JTCVS techniques · 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
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSevere endoscopically detected esophageal thermal lesions (EDELs) have been associated with higher risk of progression to atrio-esophageal fistula (AEF) following radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). We sought to evaluate safety and feasibility of active esophageal cooling using the Attune Medical Esophageal Heat Transfer Device (EnsoETM) to limit frequency or severity of EDELs.
objectiveWe sought To evaluate safety and feasibility of active esophageal cooling using the Attune Medical Esophageal Heat Transfer Device (EnsoETM) to limit frequency or severity of EDELs
methodsConsecutive patients undergoing first-time RFCA were randomized in a 1:1 fashion to esophageal cooling (device group) or standard temperature monitoring (control group). Ablation on the posterior wall was performed with a maximum power of 30W for up to 20s. All patients underwent EGD within 48 h. Endoscopy findings were classified as 1, erythema-mild injury; 2, superficial ulceration-moderate injury; 3, deep ulceration-significant injury; and 4, fistula/perforation. Severe EDELs were defined as grade 3 or 4 lesions.
resultsForty-four patients completed the study (22 device group, 22 control group). Adjunctive posterior wall isolation was performed more frequently in the device group (11/22, 50% vs. 4/22, 18%). EDELs were detected in 5/22 (23%) control group patients, with mild or moderate injury in 2/5 patients (40%) and severe thermal injury in 3/5 patients (60%). In the device group, EDELs were detected in 8/22 (36%) patients, with mild or moderate injury in 7/8 (87%) patients and severe thermal injury in 1/8 (12%) patients. There was no acute perforation or AEF during follow-up.
conclusionsActive esophageal cooling may reduce the occurrence of severe EDELs. A larger randomized study is warranted to further evaluate the benefit of this strategy.
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Registered trials
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