Evidence map›Paper›PMID 36317453›Full record

Trial reportJournal of cardiovascular electrophysiology2022

Esophageal temperature management during cryoballoon ablation for atrial fibrillation.

Joshua Sink, Kiran Nimmagadda, Manyun Zhao, Adin-Cristian Andrei, Hawkins Gay, Rachel M Kaplan, Xu Gao, Anna Pfenniger, Kaustubha D Patil, Rishi Arora and 6 more

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of cardiovascular electrophysiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Impact of Esophageal Temperature Monitoring on Esophageal Injury in PVI: A Systematic Review and Meta-Analysis.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2026
    Pooled it
  2. Trial
  3. Review
  4. Surveillance of esophageal injury after atrial fibrillation catheter ablation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2025
    Article
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 1 institution in 1 country.

Joshua SinkDepartment of Internal Medicine, Northwestern University, Chicago, Illinois, USA.
Kiran NimmagaddaDivision of Gastroenterology, Northwestern University, Chicago, Illinois, USA.
Manyun ZhaoDepartment of Preventative Medicine and Biostatistics, Northwestern University, Chicago, Illinois, USA.
Adin-Cristian AndreiDepartment of Preventative Medicine and Biostatistics, Northwestern University, Chicago, Illinois, USA.
Hawkins GayDivision of Cardiology, Northwestern University, Chicago, Illinois, USA.
Rachel M KaplanDivision of Cardiology, Northwestern University, Chicago, Illinois, USA.
Xu GaoDivision of Cardiology, Northwestern University, Chicago, Illinois, USA.
Anna PfennigerDivision of Cardiology, Northwestern University, Chicago, Illinois, USA.
Kaustubha D PatilDivision of Cardiology, Northwestern University, Chicago, Illinois, USA.ORCID 0000-0003-4592-1383
Rishi AroraDivision of Cardiology, Northwestern University, Chicago, Illinois, USA.
Susan S KimDivision of Cardiology, Northwestern University, Chicago, Illinois, USA.
Alexandru B ChicosDivision of Cardiology, Northwestern University, Chicago, Illinois, USA.ORCID 0000-0002-0291-4434
Albert C LinDivision of Cardiology, Northwestern University, Chicago, Illinois, USA.
Rod S PassmanDivision of Cardiology, Northwestern University, Chicago, Illinois, USA.
Bradley P KnightDivision of Cardiology, Northwestern University, Chicago, Illinois, USA.
Nishant VermaDivision of Cardiology, Northwestern University, Chicago, Illinois, USA.ORCID 0000-0003-4817-6614
Northwestern University · US

Funding

New and Disruptive Therapeutic Approaches to Target Fundamental Molecular Mechanisms Underlying Atrial FibrillationR35HL161249 · NHLBI · UNIVERSITY OF CHICAGO · PI Rishi Arora · 2022 to 2026
$5.1M
The identification and pathophysiology of non-infarcted but injured myocardium in the post-ischemic heartR01HL152712 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI ARORA, RISHI, ZHAO, MING · 2021 to 2024
$3.0M
NHLBI NIH HHS R01 HL152712NHLBI NIH HHS R35 HL161249
6 · The paper itself

Abstract

introductionEsophageal thermal injury (ETI) is a well-recognized complication of atrial fibrillation (AF) ablation. Previous studies have demonstrated that direct esophageal cooling reduces ETI during radiofrequency AF ablation. The purpose of this study was to evaluate the use of an esophageal warming device to prevent ETI during cryoballoon ablation (CBA) for AF.

methodsThis prospective, double-blinded study enrolled 42 patients with symptomatic AF undergoing CBA. Patients were randomized to the treatment group with esophageal warming (42°C) using recirculated water through a multilumen, silicone tube inserted into the esophagus (EnsoETM®; Attune Medical) (WRM) or the control group with a luminal single-electrode esophageal temperature monitoring probe (LET). Patients underwent upper endoscopy esophagogastroduodenoscopy (EGD) the following day. ETI was classified into four grades.

resultsBaseline patient characteristics were similar between groups. Procedural characteristics including number of freezes, total freeze time, early freeze terminations, coldest balloon temperature, procedure duration, posterior wall ablation, and proton pump inhibitor and transesophageal echocardiogram use before procedure were not different between groups. The EGD was completed in 40/42 patients. There was significantly more ETI in the WRM group compared to the LET group (n = 8 [38%] vs. n = 1 [5%], p = 0.02). All ETI lesions were grade 1 (erythema) or 2 (superficial ulceration). Total freeze time in the left inferior pulmonary vein was predictive of ETI (360 vs. 300 s, p = 0.03).

conclusionUse of a luminal heat exchange tube for esophageal warming during CBA for AF was paradoxically associated with a higher risk of ETI.

Indexed as

Atrial FibrillationCatheter AblationCryosurgeryPulmonary VeinsHumansProspective StudiesTemperatureatrial fibrillationcryoablationesophageal injuryesophageal temperature management

Identifiers

PMID36317453
PMCPMC10100377
OpenAlexW4307838735

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.