ArticleThe Journal of innovations in cardiac rhythm management2021
Impact of Active Esophageal Cooling on Fluoroscopy Usage During Left Atrial Ablation.
Article in The Journal of innovations in cardiac rhythm management, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 19 citations in OpenAlex.
- 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
- Mechanisms of action behind the protective effects of proactive esophageal cooling during radiofrequency catheter ablation in the left atrium.Heart rhythm O2 · 2024Review
- How to ablate the septo-pulmonary bundle: a case-based review of percutaneous ablation strategies to achieve roof line block.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
- 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
- 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
- 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
- Letter from the Editor in Chief.The Journal of innovations in cardiac rhythm management · 2021Article
- Improved hospital discharge and cost savings with esophageal cooling during left atrial ablation.Journal of medical economicsArticle
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Risks to collateral structures exist with radiofrequency (RF) ablation of the left atrium to obtain pulmonary vein isolation (PVI) for the treatment of atrial fibrillation. Passive luminal esophageal temperature (LET) monitoring is commonly utilized, but increasing data suggest limited benefits with LET monitoring. In contrast, active cooling of the esophagus has been shown to significantly reduce esophageal injury. Active cooling of the esophagus also avoids the need for stopping and repositioning an LET probe during use, which may reduce the need for fluoroscopy use. This study aimed to measure the impact on fluoroscopy use during RF ablation with esophageal cooling using a dedicated cooling device in a low-fluoroscopy practice. All patients who underwent PVI over a one-year timeframe by a single provider were analyzed. Patients undergoing PVI prior to the incorporation of an esophageal cooling protocol into standard ablation practice were treated with traditional LET monitoring. Patients treated after this point received active esophageal cooling, in which no LET monitoring is utilized. A total of 280 patients were treated; 91 patients were treated using LET monitoring, and 189 patients were treated with esophageal cooling. The mean total fluoroscopy time before the implementation of the esophageal cooling protocol in 91 patients was 194 seconds [standard deviation (SD): 182 seconds] per case, with a median of 144 seconds. The mean total fluoroscopy time after implementation in 189 patients was 126 seconds (SD: 120 seconds) per case with a median of 96 seconds, representing a reduction of 35% per case (p < 0.0001, Mann-Whitney U test). In this largest study to date of active esophageal cooling during PVI, a 35% reduction in fluoroscopy time compared with patients who received LET monitoring was found. This reduction was seen despite an already low fluoroscopy usage rate in place.
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