ArticleFrontiers in cardiovascular medicine2026
Esophageal deviation using the transesophageal echocardiography probe during atrial fibrillation radiofrequency ablation: a prospective observational study.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Esophageal injury is a recognized complication of atrial fibrillation (AF) radiofrequency ablation, during pulmonary vein isolation (PVI) or posterior wall ablation. Mechanical esophageal deviation has emerged as a promising preventive strategy, however, commercially available deviation tools are not accessible outside the United States. We evaluated the feasibility and effectiveness of using the transesophageal echocardiography (TEE) probe-readily available in many electrophysiology labs-for esophageal deviation during AF ablation. Methods: In this prospective observational study, patients undergoing PVI ± additional atrial ablation for AF were treated using esophageal deviation (Dev-Group) or using standard care (Std-Group) depending on the operating electrophysiologist. In the Dev-Group, esophageal position was identified using barium ingestion, and the TEE probe was manipulated to achieve maximal displacement away from posterior pulmonary vein (PV) ostia. Deviation of esophageal trailing edge >10 mm from PV was defined as successful. Esophageal temperature was monitored in both groups using a multi-sensor probe. Results: Sixty patients (30 per group; 60 PV pairs each) were included. In the Dev-Group, 78% (47/60) of PV pairs achieved >10 mm esophageal separation vs. 30% (18/60) at baseline ( Conclusion: TEE probe-guided esophageal deviation appears as a practical and effective technique for reducing esophageal proximity and thermal exposure during AF ablation, offering a valuable safety enhancement where dedicated tools are unavailable.
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